Provider Demographics
NPI:1023432408
Name:SURGICAL PARTNERS OF NORTH CAROLINA
Entity type:Organization
Organization Name:SURGICAL PARTNERS OF NORTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WON
Authorized Official - Suffix:
Authorized Official - Credentials:MD DDS PA
Authorized Official - Phone:919-469-0299
Mailing Address - Street 1:3600 NW CARY PKWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8444
Mailing Address - Country:US
Mailing Address - Phone:919-469-0299
Mailing Address - Fax:
Practice Address - Street 1:3600 NW CARY PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8444
Practice Address - Country:US
Practice Address - Phone:919-469-0299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223D0004XDental ProvidersDentistDental AnesthesiologyGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Multi-Specialty
No1223X0008XDental ProvidersDentistOral and Maxillofacial RadiologyGroup - Multi-Specialty