Provider Demographics
NPI:1346620648
Name:SPEIGHT, BIANCA (DDS)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:SPEIGHT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 GUMDROP PATH
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-1850
Mailing Address - Country:US
Mailing Address - Phone:919-210-2557
Mailing Address - Fax:
Practice Address - Street 1:4106 WAKE FOREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6398
Practice Address - Country:US
Practice Address - Phone:919-876-2464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice