Provider Demographics
NPI:1568533719
Name:WOODEN, ERNEST E III (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:E
Last Name:WOODEN
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics