Provider Demographics
NPI:1083828198
Name:GURLEY, HALL, RITTER, AND BROGDEN D.D.S, M.S., P.A.
Entity Type:Organization
Organization Name:GURLEY, HALL, RITTER, AND BROGDEN D.D.S, M.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REID
Authorized Official - Middle Name:H
Authorized Official - Last Name:BROGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-467-2419
Mailing Address - Street 1:1144 EXECUTIVE CIR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4573
Mailing Address - Country:US
Mailing Address - Phone:919-467-2419
Mailing Address - Fax:919-467-9162
Practice Address - Street 1:1144 EXECUTIVE CIR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4573
Practice Address - Country:US
Practice Address - Phone:919-467-2419
Practice Address - Fax:919-467-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35551223X0400X
NC68691223X0400X
NC67991223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty