Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 4634 | NC |
NPI | 1467479493 |
---|---|
Provider Name | Dr. Constance Arnettres Epps |
First Address | High Point, NC 27265-9227 |
Second Address | High Point, NC 27260-6707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U37852 | (02) | NC |