Provider Demographics
NPI:1124668199
Name:UDAY N REEBYE, MD, DMD, PA
Entity type:Organization
Organization Name:UDAY N REEBYE, MD, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECHNICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:F
Authorized Official - Last Name:HENAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-563-2897
Mailing Address - Street 1:321 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-2542
Mailing Address - Country:US
Mailing Address - Phone:919-269-7558
Mailing Address - Fax:
Practice Address - Street 1:321 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-2542
Practice Address - Country:US
Practice Address - Phone:919-269-7558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UDAY N REEBYE, MD, DMD, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty