Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 9797 | NC |
NPI | 1003221540 |
---|---|
Provider Name | Dr. Connie X Feng |
First Address | Apex, NC 27539-9312 |
Second Address | Apex, NC 27539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2014 |
Last Update Date | 18/01/2017 |