Provider Demographics
NPI:1215580790
Name:P.DION BEAUTY, LLC
Entity Type:Organization
Organization Name:P.DION BEAUTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEBBLES
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN-DOCKERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-906-2498
Mailing Address - Street 1:6601 OLD MONROE RD
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-5352
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6601 OLD MONROE RD
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5352
Practice Address - Country:US
Practice Address - Phone:980-858-9053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Multi-Specialty