Provider Demographics
NPI:1164567368
Name:JOEL HEDGECOE, D.D.S., P.A.
Entity Type:Organization
Organization Name:JOEL HEDGECOE, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARVIS
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:HEDGECOE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-484-6145
Mailing Address - Street 1:600 EXECUTIVE PL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5124
Mailing Address - Country:US
Mailing Address - Phone:910-484-6145
Mailing Address - Fax:910-484-2552
Practice Address - Street 1:600 EXECUTIVE PL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5124
Practice Address - Country:US
Practice Address - Phone:910-484-6145
Practice Address - Fax:910-484-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty