Organization Name: | S. ROSS PENLAND DMD PA |
NPI Number: | 1013351824 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SAMUEL ROSS PENLAND (PRESIDENT) |
Mailing Address: | 1781 Tate Blvd Se Hickory |
State: | NC US |
Postal Code: | 286024251 |
Phone Number: | 8288553779 |
Fax Number: | 8288553781 |
NPI Enumeration Date: | 04/23/2013 |
NPI Last Update Date: | 01/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 9170 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |