Provider Demographics
NPI:1114216710
Name:MESSENGER, NICOLE J (DMD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:J
Last Name:MESSENGER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 PAGE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7711
Mailing Address - Country:US
Mailing Address - Phone:919-596-1219
Mailing Address - Fax:919-596-7844
Practice Address - Street 1:2206 PAGE RD STE 103
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-7711
Practice Address - Country:US
Practice Address - Phone:585-314-8584
Practice Address - Fax:919-596-7844
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102151223G0001X
NC2601271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice