Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 7890 | NC |
NPI | 1053716324 |
---|---|
Provider Name | Mr. Earnest L Mccray |
First Address | Hope Mills, NC 28348-5759 |
Second Address | Hope Mills, NC 28348-5759 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2014 |
Last Update Date | 29/10/2014 |