Provider Demographics
NPI:1750434585
Name:WARD, WADE CHRISTOPHER (DMD)
Entity type:Individual
Prefix:DR
First Name:WADE
Middle Name:CHRISTOPHER
Last Name:WARD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7304
Mailing Address - Country:US
Mailing Address - Phone:910-350-3508
Mailing Address - Fax:910-350-3581
Practice Address - Street 1:1117 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7304
Practice Address - Country:US
Practice Address - Phone:910-350-3508
Practice Address - Fax:910-350-3581
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC67331223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics