Provider Demographics
NPI:1730262817
Name:TERRY V WOOD DMD PA
Entity type:Organization
Organization Name:TERRY V WOOD DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:910-576-3971
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:201 N MAIN
Mailing Address - City:TROY
Mailing Address - State:NC
Mailing Address - Zip Code:27371
Mailing Address - Country:US
Mailing Address - Phone:910-576-3971
Mailing Address - Fax:910-576-1090
Practice Address - Street 1:201 N MAIN
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371
Practice Address - Country:US
Practice Address - Phone:910-576-3971
Practice Address - Fax:910-576-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5684122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty