OrganizationAnderson And Slack PaDentistDental ProvidersPractice Address200 Doctors Drive, Suite F, Jacksonville, NC 28546(910) 353-4242PECOS EnrollmentBased on the most recent information from CMS, provider Anderson And Slack Pa does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1508976440Provider TypeOrganizationFull NameAnderson And Slack PaSubpartNoEnumeration Date8/30/2006Last Updated8/22/2020Contact InformationPractice LocationPractice Address200 Doctors Drive, Suite F, Jacksonville, NC 28546Phone(910) 353-4242Fax(910) 577-6421Mailing LocationMailing Address200 Doctors Drive, Suite F, Jacksonville, NC 28546Phone(910) 353-4242Fax(910) 577-6421Authorized OfficialNameAnderson, Wayne Clark (Dds)Phone(910) 353-4242Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense2996North CarolinaProvider IdentifiersIDDescriptionIssuerID2996DescriptionOtherIssuerDELTANorth CarolinaID02211DescriptionOtherIssuerBCBSNorth CarolinaID8990244DescriptionMedicaidIssuerUnlistedNorth Carolina