Provider Demographics
NPI:1427452283
Name:EAST CAROLINA UNIVERSITY
Entity type:Organization
Organization Name:EAST CAROLINA UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEAN, SCHOOL OF DENTAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:DEXTER
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:CHADWICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:252-737-7000
Mailing Address - Street 1:100 BRUNSWICK MEDICAL CENTER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BOLIVIA
Mailing Address - State:NC
Mailing Address - Zip Code:28422
Mailing Address - Country:US
Mailing Address - Phone:910-253-9000
Mailing Address - Fax:910-253-9033
Practice Address - Street 1:100 BRUNSWICK MEDICAL CENTER PKWY NE
Practice Address - Street 2:
Practice Address - City:BOLIVIA
Practice Address - State:NC
Practice Address - Zip Code:28422-1001
Practice Address - Country:US
Practice Address - Phone:910-253-9000
Practice Address - Fax:910-253-9033
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST CAROLINA UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-22
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty