Provider Demographics
NPI:1265524540
Name:TEMPLE, AUSTIN L III (DDS)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:L
Last Name:TEMPLE
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480A RYMCO DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2944
Mailing Address - Country:US
Mailing Address - Phone:336-725-9580
Mailing Address - Fax:336-725-1491
Practice Address - Street 1:1480A RYMCO DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2944
Practice Address - Country:US
Practice Address - Phone:336-725-9580
Practice Address - Fax:336-725-1491
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC61781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice