Provider Demographics
NPI:1609172329
Name:TAWIL, PETER Z (DMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:Z
Last Name:TAWIL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GOVERNORS ENDODONTICS
Mailing Address - Street 2:50201 GOVERNORS DRIVE
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517
Mailing Address - Country:US
Mailing Address - Phone:919-537-8461
Mailing Address - Fax:919-537-8461
Practice Address - Street 1:GOVERNORS ENDODONTICS
Practice Address - Street 2:50201 GOVERNORS DRIVE
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517
Practice Address - Country:US
Practice Address - Phone:919-537-8461
Practice Address - Fax:919-537-8461
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8708122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist