Provider Demographics
NPI:1598134876
Name:CHRISTOPHER M PENNISI DDS PLLC
Entity Type:Organization
Organization Name:CHRISTOPHER M PENNISI DDS PLLC
Other - Org Name:PENNISI DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:PENNISI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-834-2362
Mailing Address - Street 1:1033 OBERLIN RD
Mailing Address - Street 2:STE 120
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1199
Mailing Address - Country:US
Mailing Address - Phone:919-834-2362
Mailing Address - Fax:
Practice Address - Street 1:1033 OBERLIN RD
Practice Address - Street 2:STE 120
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1199
Practice Address - Country:US
Practice Address - Phone:919-834-2362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC8394261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental