Provider Demographics
NPI:1235004649
Name:ISAAC BOOTA, DMD, PLLC
Entity type:Organization
Organization Name:ISAAC BOOTA, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:252-227-8777
Mailing Address - Street 1:3320 US 1 HWY STE D
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27525-8438
Mailing Address - Country:US
Mailing Address - Phone:919-728-1959
Mailing Address - Fax:919-728-1956
Practice Address - Street 1:3320 US 1 HWY STE D
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:NC
Practice Address - Zip Code:27525-8438
Practice Address - Country:US
Practice Address - Phone:919-728-1959
Practice Address - Fax:919-728-1956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty