Provider Demographics
NPI:1578139499
Name:LINER, WARD & SHOBE DDS, PA
Entity Type:Organization
Organization Name:LINER, WARD & SHOBE DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:DACIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:EILERT-HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-945-5555
Mailing Address - Street 1:6570 SHALLOWFORD RD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-8651
Mailing Address - Country:US
Mailing Address - Phone:336-945-5555
Mailing Address - Fax:336-945-0125
Practice Address - Street 1:1370 PIEDMONT DR STE 200
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295-2053
Practice Address - Country:US
Practice Address - Phone:336-249-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINER, WARD & SHOBE DDS, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-01
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty