Provider Demographics
NPI:1699213843
Name:CHANG AND RAMOS DDS PA
Entity Type:Organization
Organization Name:CHANG AND RAMOS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-345-9511
Mailing Address - Street 1:3901 N ROXBORO ST
Mailing Address - Street 2:STE 111
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2181
Mailing Address - Country:US
Mailing Address - Phone:919-479-1300
Mailing Address - Fax:
Practice Address - Street 1:3901 N ROXBORO ST
Practice Address - Street 2:STE 111
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2181
Practice Address - Country:US
Practice Address - Phone:919-479-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty