Benjamin Mithrandir Magleby | Jacksonville, NC • PECOS Search

Benjamin Mithrandir Magleby

Dentist

Dental Providers

142 Plow Point Ln, Jacksonville, NC 28546-9591

PECOS Enrollment

Based on the most recent information from CMS, provider Benjamin Mithrandir Magleby 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 yesterday at 11:51 AM.

Profile Details

Provider ID
1093785222
Provider Type
Individual
Full Name
Magleby, Benjamin Mithrandir
Title
Dr.

Gender
Male
Sole Proprietor
No
Enumeration Date
1/23/2006
Last Updated
5/19/2008

Contact Information

Practice Location

142 Plow Point Ln, Jacksonville, NC 28546-9591

Unlisted Fax

Mailing Location

142 Plow Point Ln, Jacksonville, NC 28546-9591

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License 53828 California