Provider Demographics
NPI:1801412655
Name:STATON, TREVOR WILLIAM (DMD)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:WILLIAM
Last Name:STATON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 LOW GAP RD
Mailing Address - Street 2:
Mailing Address - City:HAYESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28904-6237
Mailing Address - Country:US
Mailing Address - Phone:828-361-0021
Mailing Address - Fax:
Practice Address - Street 1:581 W PALMER ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-3014
Practice Address - Country:US
Practice Address - Phone:828-524-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11948122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist