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Organization

TUCKER & ALLEN-JOHNSON DDS PA

Active
Other names
Smile Junction Pediatric Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NIKKI GIOVONNE TUCKER DDS (PRESIDENT)
(336) 538-1608
Entity
Organization

Contact information

Practice address
2975 CROUSE LANE, BURLINGTON, NC 27215-8833
(336) 538-1608
Mailing address
2975 CROUSE LANE, BURLINGTON, NC 27215-8833
(336) 538-1608

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7497
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019VY
NORTH CAROLINA HEALTH CHOICE/GROUP
NC
01
0902UH
NORTH CAROLINA HEALTH CHOICE/INDIVIDUAL
NC
01
092TV
NORTH CAROLINA HEALTH CHOICE/INDIVIDUAL
NC
05
89902TV
NC
Enumeration date
10/01/2007
Last updated
01/12/2011
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