Provider Demographics
NPI:1306950605
Name:VOLLMER, JAMES M (DDA, PA)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:VOLLMER
Suffix:
Gender:M
Credentials:DDA, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:15 POPLAR STREET
Mailing Address - City:ANDREWS
Mailing Address - State:NC
Mailing Address - Zip Code:28901-0460
Mailing Address - Country:US
Mailing Address - Phone:828-321-5413
Mailing Address - Fax:828-321-3521
Practice Address - Street 1:15 POPLAR ST.
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:NC
Practice Address - Zip Code:28901-0460
Practice Address - Country:US
Practice Address - Phone:828-321-5413
Practice Address - Fax:828-321-3521
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8998798Medicaid