TRACIE L. VESTAL DDS PA
NPI 1508039405
Clinic/Center - Dental in Elizabethtown, NC

Active since April 11, 2008
500 W BROAD ST, ELIZABETHTOWN, NC 28337(910) 862-4078 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Tracie L. Vestal Dds Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACIE L. VESTAL DDS PA (NPI 1508039405) is a healthcare organization registered as a dental in Elizabethtown, North Carolina and active in the NPI registry since April 2008. The organization lists Tracie Leigh Vestal, Owner, as its authorized official.

NPPES Registry Identity

NPI1508039405
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameTRACIE L. VESTAL DDS PA
Location Address500 W BROAD STElizabethtown, NC 28337-9411
Mailing Address500 W Broad StElizabethtown, NC 28337-9411 · (910) 862-4078
Organization SubpartNo
Authorized OfficialTracie Leigh VestalOwner · (910) 862-4078
Enumeration DateApril 11, 2008
Last NPPES UpdateMarch 7, 2023
NPI 1508039405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License Licensed in NC · 7200
500 W BROAD ST, Elizabethtown, NC 28337

Other Identifiers 3

Other7200NC · Nc License
Other902ECNC · Bcbs Provider #
Medicaid89902ECNC

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
500 W BROAD ST
ELIZABETHTOWN, NC 28337

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508039405, enumerated as an "organization" on April 11, 2008.

The provider is located at 500 W BROAD ST ELIZABETHTOWN, NC 28337 and the phone number is (910) 862-4078.

Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.