Individual
JACK TYLER WINCHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3705 SYMI CIRCLE DRIVE, MOREHEAD CITY, NC 28557
(252) 247-3510
(252) 247-6197
Mailing address
3705 SYMI CIRCLE DRIVE, MOREHEAD CITY, NC 28557
(252) 247-3510
(252) 247-6197
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5372
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8999423
—
NC
Enumeration date
08/25/2006
Last updated
03/07/2023
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