Provider Demographics
NPI:1851773675
Name:DIAZ, FRANQUIL NELSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANQUIL
Middle Name:NELSON
Last Name:DIAZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MOORE ST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-2217
Mailing Address - Country:US
Mailing Address - Phone:919-360-3524
Mailing Address - Fax:
Practice Address - Street 1:104C ADAIR DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-4516
Practice Address - Country:US
Practice Address - Phone:919-648-4437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10094122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist