Provider Demographics
NPI:1629143391
Name:TOWNSEND & TOWNSEND DDS
Entity Type:Organization
Organization Name:TOWNSEND & TOWNSEND DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DR
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-892-7370
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334
Mailing Address - Country:US
Mailing Address - Phone:910-892-7370
Mailing Address - Fax:910-892-1331
Practice Address - Street 1:212 N WILSON AVE
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334
Practice Address - Country:US
Practice Address - Phone:910-892-7370
Practice Address - Fax:910-892-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC45181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
98514OtherBCBS
NC8998514Medicaid