Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 11587 | NC |
NPI | 1225679509 |
---|---|
Provider Name | Dr. Robert David Price |
First Address | Hickory, NC 28602-9695 |
Second Address | Hickory, NC 28602-9695 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2019 |
Last Update Date | 08/10/2019 |