OrganizationKingsley Momodu, Dds & Associates, Pllc(<Unavail>)Clinic/CenterAmbulatory Health Care FacilitiesPractice Address2901 Breezewood Ave, Suite 101, Fayetteville, NC 28303-5409(443) 762-1987PECOS EnrollmentBased on the most recent information from CMS, provider Kingsley Momodu, Dds & Associates, Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 10 days ago.Profile DetailsProvider ID1801148457Provider TypeOrganizationFull NameKingsley Momodu, Dds & Associates, PllcOther Name<Unavail>SubpartNoEnumeration Date10/6/2012Last Updated5/11/2023Contact InformationPractice LocationPractice Address2901 Breezewood Ave, Suite 101, Fayetteville, NC 28303-5409Phone(443) 762-1987FaxUnlisted FaxMailing LocationMailing Address2901 Breezewood Ave, Suite 101, Fayetteville, NC 28303-5409Phone(443) 762-1987FaxUnlisted FaxAuthorized OfficialNameMomodu, Kingsley Oise (Dental Surgeon/Proprietor)Phone(443) 762-1987Provider TaxonomiesCodeDescriptionLicenseCode261QD0000XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicense#9234North Carolina