Provider Demographics
NPI:1316388481
Name:PRESSLEY, KNOCKUM, AND ASSOCIATES, D.D.S., P.A.
Entity Type:Organization
Organization Name:PRESSLEY, KNOCKUM, AND ASSOCIATES, D.D.S., P.A.
Other - Org Name:PREMIER SMILES OF CHARLOTTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-433-7333
Mailing Address - Street 1:8311 BRIER CREEK PKWY
Mailing Address - Street 2:SUITE 105123
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7328
Mailing Address - Country:US
Mailing Address - Phone:919-433-7333
Mailing Address - Fax:
Practice Address - Street 1:2303 W MOREHEAD ST
Practice Address - Street 2:SUITE 103
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5186
Practice Address - Country:US
Practice Address - Phone:704-817-8728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC90411223G0001X
PA94761223G0001X
NC92321223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty