Provider Demographics
NPI:1861496887
Name:DAWSON, TERRY WAYNE (DOS)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:WAYNE
Last Name:DAWSON
Suffix:
Gender:M
Credentials:DOS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 EASTCHESTER DR
Mailing Address - Street 2:STE 101
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1488
Mailing Address - Country:US
Mailing Address - Phone:336-889-9916
Mailing Address - Fax:336-889-9159
Practice Address - Street 1:1817 EASTCHESTER DR
Practice Address - Street 2:STE 101
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1488
Practice Address - Country:US
Practice Address - Phone:336-889-9916
Practice Address - Fax:336-889-9159
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52821223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health