Provider Demographics
NPI:1164563920
Name:CARD, REX BROWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:REX
Middle Name:BROWN
Last Name:CARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 SALEM WOODS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3345
Mailing Address - Country:US
Mailing Address - Phone:919-870-0550
Mailing Address - Fax:919-870-8024
Practice Address - Street 1:808 SALEM WOODS DR STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3345
Practice Address - Country:US
Practice Address - Phone:919-870-0550
Practice Address - Fax:919-870-8024
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC47521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice