Provider Demographics
NPI:1508279753
Name:JAMES T CASEY II, PLLC
Entity Type:Organization
Organization Name:JAMES T CASEY II, PLLC
Other - Org Name:CASEY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-751-0556
Mailing Address - Street 1:204 W ARLINGTON BOULEVARD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5762
Mailing Address - Country:US
Mailing Address - Phone:252-751-0556
Mailing Address - Fax:252-751-0564
Practice Address - Street 1:204 W ARLINGTON BOULEVARD
Practice Address - Street 2:SUITE B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5762
Practice Address - Country:US
Practice Address - Phone:252-751-0556
Practice Address - Fax:252-751-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty