Provider Demographics
NPI:1093987612
Name:TAMMY R. SEVERT, DDS, PA
Entity Type:Organization
Organization Name:TAMMY R. SEVERT, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:SEVERT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:919-929-2365
Mailing Address - Street 1:101 CONNER DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7038
Mailing Address - Country:US
Mailing Address - Phone:919-929-2365
Mailing Address - Fax:919-967-2712
Practice Address - Street 1:101 CONNER DR
Practice Address - Street 2:SUITE 401
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7038
Practice Address - Country:US
Practice Address - Phone:919-929-2365
Practice Address - Fax:919-967-2712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC63841223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty