Individual
LUISITO MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2030 OLD DENTAL BLDG, CHAPEL HILL, NC 27599-7455
(919) 537-3417
Mailing address
5612 CAREY PL, DURHAM, NC 27712-4011
(919) 489-1231
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0087
NC
Other
Enumeration date
11/18/2015
Last updated
11/18/2015
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