Lee Patrick Dickinson | Jacksonville, NC • PECOS Search

Lee Patrick Dickinson

Dentist

Dental Providers

3847 Henderson Dr, Jacksonville, NC 28546-5228

PECOS Enrollment

Based on the most recent information from CMS, provider Lee Patrick Dickinson 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 2 days ago.

Profile Details

Provider ID
1124758198
Provider Type
Individual
Full Name
Dickinson, Lee Patrick
Credential
DMD

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/13/2022
Last Updated
6/13/2022

Contact Information

Practice Location

3847 Henderson Dr, Jacksonville, NC 28546-5228

Unlisted Fax

Mailing Location

212 Bebington Dr, Cary, NC 27513-1748

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License 12800 North Carolina