Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | NC3075 | NC |
NPI | 1003974072 |
---|---|
Provider Name | Dr. Kent Waddell Healey |
First Address | Chapel Hill, NC 27514-9011 |
Second Address | Chapel Hill, NC 27514-2619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 08/07/2007 |