Provider Demographics
NPI:1962886325
Name:LINDSEY M METCALF DDS PLLC
Entity type:Organization
Organization Name:LINDSEY M METCALF DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:METCALF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-993-4474
Mailing Address - Street 1:123 BROAD ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-2925
Mailing Address - Country:US
Mailing Address - Phone:336-993-4474
Mailing Address - Fax:336-993-4474
Practice Address - Street 1:123 BROAD ST
Practice Address - Street 2:SUITE 1
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2925
Practice Address - Country:US
Practice Address - Phone:336-993-4474
Practice Address - Fax:336-993-4474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC80091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty