Provider Demographics
NPI:1922390392
Name:JAMES M. VOLLMER DDS PA
Entity Type:Organization
Organization Name:JAMES M. VOLLMER DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:VOLLMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PA
Authorized Official - Phone:828-321-5413
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:NC
Mailing Address - Zip Code:28901-0460
Mailing Address - Country:US
Mailing Address - Phone:828-321-5413
Mailing Address - Fax:828-321-3521
Practice Address - Street 1:15 POPLAR ST.
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:NC
Practice Address - Zip Code:28901
Practice Address - Country:US
Practice Address - Phone:828-321-5413
Practice Address - Fax:828-321-3521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38381223D0001X
NC90061223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5916218Medicaid
NC8998798Medicaid