Provider Demographics
NPI:1861874919
Name:UNIVERSITY OF NORTH CAROLINA CHAPEL HILL
Entity type:Organization
Organization Name:UNIVERSITY OF NORTH CAROLINA CHAPEL HILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL ASSISTANT PROFESSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERA RESENDIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:919-428-0522
Mailing Address - Street 1:MANNING DR & COLUMBIA ST
Mailing Address - Street 2:UNC SCHOOL OF DENTISTRY -DEPARTMENT OF PROSTHODONTICS
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:919-537-3437
Mailing Address - Fax:919-537-3977
Practice Address - Street 1:MANNING DR & COLUMBIA ST
Practice Address - Street 2:UNC SCHOOL OF DENTISTRY -DEPARTMENT OF PROSTHODONTICS
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-537-3437
Practice Address - Fax:919-537-3977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental