Provider Demographics
NPI:1134879844
Name:MCCUMBEE, CAROLINE HAWKINS (DDS)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:HAWKINS
Last Name:MCCUMBEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 CREST ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-1630
Mailing Address - Country:US
Mailing Address - Phone:704-648-9444
Mailing Address - Fax:
Practice Address - Street 1:225 S HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-1643
Practice Address - Country:US
Practice Address - Phone:704-648-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC127701223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice