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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. ANTHONY RUSSELL IMMEDIATA, DMD, PA

Active Sole Proprietor

DR. ANTHONY RUSSELL IMMEDIATA, DMD, PA is a Oral & Maxillofacial Surgery healthcare provider located in RALEIGH, North Carolina. NPI 1609809292 is currently active in the NPPES registry. Verify at CMS.

Oral & Maxillofacial Surgery · RALEIGH, NC

Registration Details

NPI Number
1609809292
Provider Type
Individual
Gender
Male
NPI Issued
Jul 8, 2006 (20.060037774161 yrs)
Last Updated
Jul 8, 2007
License
5022 (NC)
Sole Proprietor
Yes

Practice Information

Address
7101 CREEDMOOR RD
SUITE 109
RALEIGH, NC, 276131682
Browse NC providers · Browse ZIP 27613
Phone
9198465500
Primary Specialty
Oral & Maxillofacial Surgery
1223S0112X

Other Oral & Maxillofacial Surgery Providers in RALEIGH, NC

Name Credential NPI
DR. MICHAEL L. POTTER 1609847342
DR. KHASHAYAR KEVIN NESHAT DDS, MD 1992755524
DR. KENNETH J. BENSON D.D.S. 1326099458
DR. MARK FRANKLIN KOZACKO DDS PA 1952337685
DR. SCOTT ALAN HUM DMD, MS 1740216456
ROY E GAINES JR. D.D.S., M.D. 1679675292
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.