Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 5706 | NC |
NPI | 1114938941 |
---|---|
Provider Name | Richard Mckinnon Forbes |
First Address | Boone, NC 28607 |
Second Address | Boone, NC 28607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |