Jeremiah C Davis, Dds, Mba, Pa | Fayetteville, NC • PECOS Search

Jeremiah C Davis, Dds, Mba, Pa

(<Unavail>)

Clinic/Center

Ambulatory Health Care Facilities

6402 Yadkin Rd, Fayetteville, NC 28303

PECOS Enrollment

Based on the most recent information from CMS, provider Jeremiah C Davis, Dds, Mba, Pa does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 10 days ago.

Profile Details

Provider ID
1811497761
Provider Type
Organization
Full Name
Jeremiah C Davis, Dds, Mba, Pa
Other Name
<Unavail>

Subpart
No
Enumeration Date
2/16/2018
Last Updated
10/29/2020

Contact Information

Practice Location

6402 Yadkin Rd, Fayetteville, NC 28303

Unlisted Fax

Mailing Location

7151 Okelly Chapel Rd # 318, Cary, NC 27519-6849

Unlisted Fax

Authorized Official

Davis, Jeremiah C (Owner)

Provider Taxonomies

Code	Description	License
Code 261QD0000X Primary	Description Clinic/Center Ambulatory Health Care Facilities	License 9774 North Carolina