Provider Demographics
NPI:1841323169
Name:WAYNE COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:WAYNE COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFINEY
Authorized Official - Middle Name:TYLAINE
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-705-1931
Mailing Address - Street 1:368 TEELS ESTATE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-9285
Mailing Address - Country:US
Mailing Address - Phone:252-902-7068
Mailing Address - Fax:
Practice Address - Street 1:301 N HERMAN ST
Practice Address - Street 2:SUITE CC
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-2973
Practice Address - Country:US
Practice Address - Phone:919-705-1931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC70931223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty