Provider Demographics
NPI:1689774606
Name:DAVID H. CLINE, IV, D.D.S., P.A.
Entity Type:Organization
Organization Name:DAVID H. CLINE, IV, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:CLINE
Authorized Official - Suffix:IV
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-835-2725
Mailing Address - Street 1:500 PARKWOOD MEDICAL PARK
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2486
Mailing Address - Country:US
Mailing Address - Phone:336-835-2725
Mailing Address - Fax:336-835-2740
Practice Address - Street 1:500 PARKWOOD MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2486
Practice Address - Country:US
Practice Address - Phone:336-835-2725
Practice Address - Fax:336-835-2740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty