Provider Demographics
NPI:1780992487
Name:PAYNE, ANNE MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9615 CALDWELL COMMONS CIR STE A
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-8188
Mailing Address - Country:US
Mailing Address - Phone:704-896-8452
Mailing Address - Fax:
Practice Address - Street 1:9615 CALDWELL COMMONS CIR STE A
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8188
Practice Address - Country:US
Practice Address - Phone:704-896-8452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC113261223X0400X
KY86311223X0400X
IN12011748A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty