Provider Demographics
NPI:1215274428
Name:HEDGECOE DENTISTRY
Entity type:Organization
Organization Name:HEDGECOE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:HEDGECOE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-484-6145
Mailing Address - Street 1:600 EXECUTIVE PL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5124
Mailing Address - Country:US
Mailing Address - Phone:910-484-6145
Mailing Address - Fax:910-484-2552
Practice Address - Street 1:600 EXECUTIVE PL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5124
Practice Address - Country:US
Practice Address - Phone:910-484-6145
Practice Address - Fax:910-484-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty