Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 5290 | NC |
NPI | 1013992932 |
---|---|
Provider Name | Dr. William Francis Freccia |
First Address | Fayetteville, NC 28304-4441 |
Second Address | Fayetteville, NC 28304-4441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U35473 | (02) | NC |