Provider Demographics
NPI:1487685046
Name:SYKES, ROSCOE ANDREWS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSCOE
Middle Name:ANDREWS
Last Name:SYKES
Suffix:
Gender:M
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:PO BOX 875
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:27298-0875
Mailing Address - Country:US
Mailing Address - Phone:336-622-2953
Mailing Address - Fax:
Practice Address - Street 1:524 N. GREENSBORO STREET
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:27298-0875
Practice Address - Country:US
Practice Address - Phone:336-622-2953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC41221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice