Provider Demographics
NPI:1164947552
Name:JAMES WOODFORD, DDS
Entity Type:Organization
Organization Name:JAMES WOODFORD, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:WOODFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-486-5511
Mailing Address - Street 1:PO BOX 87214
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-7214
Mailing Address - Country:US
Mailing Address - Phone:910-486-5511
Mailing Address - Fax:910-223-7359
Practice Address - Street 1:2550 RAVENHILL DR STE 101
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-9628
Practice Address - Country:US
Practice Address - Phone:910-486-5511
Practice Address - Fax:910-223-7359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5466261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental