Provider Demographics
NPI:1316018567
Name:ERNEST E. WOODEN, III, D.D.S., P.A.
Entity Type:Organization
Organization Name:ERNEST E. WOODEN, III, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:E
Authorized Official - Last Name:WOODEN
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-471-1036
Mailing Address - Street 1:3925 N DUKE ST STE 121
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-1780
Mailing Address - Country:US
Mailing Address - Phone:919-471-1036
Mailing Address - Fax:919-479-1630
Practice Address - Street 1:3925 N DUKE ST STE 121
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-1780
Practice Address - Country:US
Practice Address - Phone:919-471-1036
Practice Address - Fax:919-479-1630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3629261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental