Provider Demographics
NPI:1154820355
Name:ERIC D. HOVERSTAD, DDS, PLLC
Entity Type:Organization
Organization Name:ERIC D. HOVERSTAD, DDS, PLLC
Other - Org Name:NORTH HILLS IMPLANT & ORAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:DEUBLER
Authorized Official - Last Name:HOVERSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-298-2820
Mailing Address - Street 1:3809 COMPUTER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6518
Mailing Address - Country:US
Mailing Address - Phone:919-298-2820
Mailing Address - Fax:919-844-2856
Practice Address - Street 1:3809 COMPUTER DR STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6518
Practice Address - Country:US
Practice Address - Phone:919-298-2820
Practice Address - Fax:919-844-2856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-03
Last Update Date:2018-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC89341223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty