Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 0084 | NC |
NPI | 1083823397 |
---|---|
Provider Name | Dr. Preeda Pungpapong |
First Address | Chapel Hill, NC 27516-8754 |
Second Address | Chapel Hill, NC 27599-7450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |