Provider Demographics
NPI:1083128797
Name:GEESON, ROOKS AND ASSOCIATES, DDS, PA
Entity Type:Organization
Organization Name:GEESON, ROOKS AND ASSOCIATES, DDS, PA
Other - Org Name:COMPLETE DENTAL CHADBOURN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRYSTAL
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-361-8063
Mailing Address - Street 1:7087 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SURF CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28445-8646
Mailing Address - Country:US
Mailing Address - Phone:252-361-8063
Mailing Address - Fax:
Practice Address - Street 1:711 N BROWN ST
Practice Address - Street 2:
Practice Address - City:CHADBOURN
Practice Address - State:NC
Practice Address - Zip Code:28431
Practice Address - Country:US
Practice Address - Phone:252-361-8062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-17
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8443122300000X
NCNC99911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1154528602OtherNPI
NC1700446184OtherNPI