Provider Demographics
NPI:1831409630
Name:HARROLD & ASSOCIATES II DDS PA
Entity type:Organization
Organization Name:HARROLD & ASSOCIATES II DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-977-6440
Mailing Address - Street 1:105 WAYFARER COURT
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801
Mailing Address - Country:US
Mailing Address - Phone:252-977-6440
Mailing Address - Fax:252-977-3155
Practice Address - Street 1:105 WAYFARER COURT
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801
Practice Address - Country:US
Practice Address - Phone:252-977-6440
Practice Address - Fax:252-977-3155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty