Provider Demographics
NPI:1639578214
Name:SCHOOL OF DENTISTRY, UNIVERSITY OF NORTH CAROLINA
Entity Type:Organization
Organization Name:SCHOOL OF DENTISTRY, UNIVERSITY OF NORTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PROFESSOR/DIRECTOR DFP
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-537-3657
Mailing Address - Street 1:436 BRAUER HALL CLB # 7450
Mailing Address - Street 2:DEPT. OF OPERATIVE DENTISTRY, UNC SCHOOL OF DENTISTRY
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:436 BRAUER HALL CLB # 7450
Practice Address - Street 2:DEPT. OF OPERATIVE DENTISTRY, UNC SCHOOL OF DENTISTRY
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-537-3440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0143284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital