Provider Demographics
NPI:1811392566
Name:JEFFREY D EFIRD DDS PLLC
Entity Type:Organization
Organization Name:JEFFREY D EFIRD DDS PLLC
Other - Org Name:CAROLINA MOUNTAIN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-252-6541
Mailing Address - Street 1:11 YORKSHIRE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2893
Mailing Address - Country:US
Mailing Address - Phone:828-252-6541
Mailing Address - Fax:828-252-1784
Practice Address - Street 1:11 YORKSHIRE ST
Practice Address - Street 2:SUITE B
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2893
Practice Address - Country:US
Practice Address - Phone:828-252-6541
Practice Address - Fax:828-252-1784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5661261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental