Provider Demographics
NPI:1629080361
Name:PREWITT & PREWITT, PA
Entity Type:Organization
Organization Name:PREWITT & PREWITT, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBINSON
Authorized Official - Last Name:PREWITT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-484-7878
Mailing Address - Street 1:PO BOX 53662
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-3662
Mailing Address - Country:US
Mailing Address - Phone:910-484-7878
Mailing Address - Fax:910-484-0505
Practice Address - Street 1:203 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5511
Practice Address - Country:US
Practice Address - Phone:910-484-7878
Practice Address - Fax:910-484-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty