Provider Demographics
NPI:1942328661
Name:ARRIBAS, MODESTO C (DMD)
Entity Type:Individual
Prefix:DR
First Name:MODESTO
Middle Name:C
Last Name:ARRIBAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 STEVENS MILLS RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-8009
Mailing Address - Country:US
Mailing Address - Phone:919-731-2023
Mailing Address - Fax:919-731-2048
Practice Address - Street 1:701 STEVENS MILLS RD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-8009
Practice Address - Country:US
Practice Address - Phone:919-731-2023
Practice Address - Fax:919-731-2048
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1504841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice