Provider Demographics
NPI:1295496495
Name:LAURENCE R MESTER JR DDS AND ASSOCIATES III PA
Entity type:Organization
Organization Name:LAURENCE R MESTER JR DDS AND ASSOCIATES III PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JING
Authorized Official - Middle Name:
Authorized Official - Last Name:MESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-633-1306
Mailing Address - Street 1:468 NC 24-87
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326-6808
Mailing Address - Country:US
Mailing Address - Phone:919-633-1306
Mailing Address - Fax:
Practice Address - Street 1:3218 BRAGG BLVD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303
Practice Address - Country:US
Practice Address - Phone:916-633-1306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty