Provider Demographics
NPI:1861826109
Name:KINCAID FAMILY DENTISTRY
Entity Type:Organization
Organization Name:KINCAID FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:IRAN
Authorized Official - Last Name:KINCAID
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-636-0011
Mailing Address - Street 1:635 MCCARTHY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5232
Mailing Address - Country:US
Mailing Address - Phone:252-636-0011
Mailing Address - Fax:
Practice Address - Street 1:635 MCCARTHY BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5232
Practice Address - Country:US
Practice Address - Phone:252-636-0011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty