Dentist Providers In Camp Lejeune, North Carolina

Search Dentist NPI records in Camp Lejeune, NC

Search or browse through the NPI records of dentist registered healthcare providers with a business address in Camp Lejeune, NC. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 137, all registered as individuals. A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

100% Individuals

28% Female

72% Male

100% Individual Providers (137)28% Female Providers (38)72% Male Providers (99)

Map of Providers

We have mapped the Dentist providers in Camp Lejeune, NC to visually represent the practice location of each individual or organization. Click on any of the the pins to see the provider details at that location.

List of Providers

Table of Dentist NPI Profiles in Camp Lejeune, NC
NPI	Name	Address	Insurance	Medicare	PECOS
1003654740	MATTHEW MANLEY (Individual)	COMMANDING OFFICER, NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1013029768	MICHAEEL JULIAN WOLFGANG (Individual)	315 MCHUGH BLVD 2D DEN BN / NDC CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1013568179	MATTHEW AUSTIN BRITT (Individual)	COMMANDING OFFICER 2D DENBN/NDC 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208	Delta Dental of North Carolina	Non-Participating Provider	NO
1023082823	MARC EDWARD ARENA (Individual)	315 MCHUGH BLVD 2D DEN BN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1033094511	JASMINE BREE GONZALES (Individual)	COMMANDING OFFICER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28445 (910) 450-2208		Non-Participating Provider	NO
1033250345	STEPHEN JOSEPH CONNELLY (Individual)	315 MCHUGH BLVD CAMP LEJEUNE, NC 28547 (910) 451-8866		Non-Participating Provider	NO
1043522014	JEFFREY MICHAEL GREGSON (Individual)	2D DENBN/NDC, PSC BOX 20130 315 MCHUGH BLVD COMMANDING OFFICER CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1043652563	TYLER EUGENE YAHNKE (Individual)	COMMANDING OFFICER 2D DENBN/NDC PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28540 (910) 451-2208	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1043687759	MICHAEL DAVID HOGLUND (Individual)	315 MCHUGH BLVD 2D DENBN/NDC PSC 20130 COMMANDING OFFICER CAMP LEJEUNE, NC 28542 (910) 451-2208	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Humana Paramount Paramount Dental	Non-Participating Provider	NO
1053699454	EMERSON FRANKLIN GOWER (Individual)	315 MCHUGH BLVD 2D DENBN/NDC, PSC BOX 20130 COMMANDING OFFICER CAMP LEJEUNE, NC 28542 (910) 451-2208	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas BlueCross BlueShield of South Carolina Guardian Humana Renaissance Dental	Non-Participating Provider	NO
1063724029	JAMES ALLAN SHAUL (Individual)	700 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 450-1658		Non-Participating Provider	NO
1073194270	BENJAMIN ROBERT GOSSELIN (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-4357	Delta Dental of North Carolina	Non-Participating Provider	NO
1073393328	MARK BRENT HOSEA (Individual)	COMMANDING OFFICER NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1073771994	JAMES PALMER FETNER (Individual)	315 MCHUGH BLVD 2D DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208	Delta Dental of North Carolina	Non-Participating Provider	NO
1083378616	RYAN A MCCOLLUM (Individual)	2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1093794364	WILLIAM JOHN LEONARD (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION / NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1114702909	MARCIA KIM (Individual)	NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1114759636	BRIGID MARY BANE (Individual)	BLDG FC-308, H M SMITH BLVD CAMP LEJEUNE, NC 28547 (910) 451-1720		Non-Participating Provider	NO
1124010764	KATHY S WARNER (Individual)	315 MCHUGH BLVD 2D DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Arizona	Non-Participating Provider	NO
1124450028	DANIELLE PAIGE BERKOWITZ (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (760) 725-8882	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of NC Delta Dental of North Carolina Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1124499520	HEE YOUNG HWANG (Individual)	315 MCHUGH BLVD COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208	Florida Combined Life Guardian TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1144003930	ROSEMARY J HINSON (Individual)	COMMANDING OFFICER, NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1144291311	KENT GORE (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/ NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1154301067	JOHN TURNER WEISNER (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1174835144	KRISTOPHER PAUL CHILCUTT (Individual)	2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD COMMANDING OFFICER CAMP LEJEUNE, NC 28542 (910) 451-2208	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1184340820	ALLENDE R ESQUIVEL (Individual)	COMMANDING OFFICER 2D DENBN/NDC, PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1184716029	JEFFREY A DRAUDE (Individual)	315 MCHUGH BLVD 2 D DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1205816154	CLARA YANITSA LLODRA (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208	Ambetter Health Ambetter of Alabama Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Blue (BlueCross BlueShield FL) Florida Blue HMO (a BlueCross BlueShield FL company) Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Maybe Accepts Medicare	YES
1215129861	DONNA M. GENTRY (Individual)	315 MCHUGH BLVD 2D DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208	Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of North Carolina Dominion National EMI Health Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	YES
1215368527	CHASE WESTHALL FETTERS (Individual)	COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1215627039	JAKE ANDREW COLLINS (Individual)	BLDG 309 HM SMITH BLVD. CAMP LEJEUNE, NC 28547 (910) 451-1720		Non-Participating Provider	NO
1225745367	JAIRO ROSARIO JIMENEZ (Individual)	COMMANDING OFFICER 2D DENBN/NDC, PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1225869985	MICHAEL TYLER NEAL (Individual)	COMMANDING OFFICER, NAVAL MEDICAL CENTER CAMP LEJEUNE 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-4357		Non-Participating Provider	NO
1245547488	CHARLES MICHAEL KEANE (Individual)	315 MCHUGH BLVD COMMANDING OFFICER 2D DENBN/NDC PSC BOX 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208	Delta Dental of Wisconsin Inc.	Non-Participating Provider	YES
1255012761	CARSTEN DANIEL HELVIE (Individual)	NAVAL HOSPITAL CAMP LEJEUNE 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1275052417	PAIGE ROLAND GRATER (Individual)	315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208	Blue Cross and Blue Shield of NC Delta Dental of North Carolina	Non-Participating Provider	NO
1275207144	DANIEL HUANG (Individual)	165 I ST CAMP LEJEUNE, NC 28547 (910) 451-1013	Aetna CVS Health Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Delta Dental of North Carolina Dominion National Florida Combined Life Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	YES
1285207712	SETH SNYDER (Individual)	2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1285276428	AUSTIN S WHITMORE (Individual)	COMMANDING OFFICER 2D DENBN/NDC PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2220		Non-Participating Provider	NO
1285941591	NATHAN RICHARD MARTZKE (Individual)	315 MCHUGH BLVD COMMANDING OFFICER 2D DENBN/NDC, PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Blue Cross Blue Shield of Michigan Mutual Insurance Company Delta Dental of Michigan Dominion National EMI Health Florida Combined Life Humana Paramount Paramount Dental	Non-Participating Provider	YES
1295015436	MATTHEW ADAM ROUSE (Individual)	315 MCHUGH BLVD 2D DENBN/NDC COMMANDING OFFICER CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1295565091	QUAID A RUSSELL (Individual)	COMMANDING OFFICER, NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1306855432	JEFFREY ALLEN MOOS (Individual)	PSC BOX 20130 2D DENBN/NDC CAMP LEJEUNE, NC 28542 (910) 451-2208	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana	Non-Participating Provider	NO
1326872474	BRYAN PATRICK CHICO (Individual)	COMMANDING OFFICER, NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 330-0415		Non-Participating Provider	NO
1336451301	KRISTINA BROOKE MENDOZA (Individual)	2D DENBN/NDC PSC 20130 315 MCHUGH BLVD COMMANDING OFFICER CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1336820018	KAMERON JAMES MILAN (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-0836		Non-Participating Provider	NO
1356028385	TERRANCE TYLER RECEVEUR (Individual)	BUILDING NH-100, FLOOR 2 CAMP LEJEUNE, NC 28542 (910) 451-2414		Non-Participating Provider	NO
1356078034	MELISSA KERR (Individual)	COMMANDING OFFICER, PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1366056624	THOMAS JAMES GILLCRIST (Individual)	COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Companion Life Insurance Company Delta Dental of Wisconsin Inc. Dominion National Florida Combined Life Guardian Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1366421976	LOREN JAMES STEENSON (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1376328146	JASON PHEN (Individual)	NAVAL MEDICAL CENTER, 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1376529073	DAVID ALAN RUSSELL (Individual)	2D DENTAL BATTALION NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1376954495	JIAMING GENG (Individual)	COMMANDING OFFICER 2D DENBN/NDC, PSC 20130, 315 MCHUGH BLVD CAMP LEJEUNE, NC 28540 (910) 451-2208	Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee WellCare of North Carolina	Non-Participating Provider	NO
1386308708	HANNAH MARIA HEAIR (Individual)	2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1386623916	JOSEPH WERRELL (Individual)	315 MCHUGH BLVD 2ND DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-5705		Non-Participating Provider	NO
1386623965	MARK P JOHNSON (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-8036		Non-Participating Provider	NO
1396472692	BUENIEL KIM (Individual)	COMMANDING OFFICER 2D DENBN/NDC, PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1396724423	DON CHARLTON ELLZEY (Individual)	315 MCHUGH BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1417155409	CHRISTOPHER NORMAN BEALE (Individual)	315 MCHUGH BLVD 2D DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas CareSource Delta Dental of Ohio DentaQuest Insurance Company Inc- OH Dominion National Guardian Humana MedMutual Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1417244674	MICHAEL LEE PAYNE (Individual)	2D DENBN/NDC COMMANDING OFFICER CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1417396847	NOEL EVAN DICKENS (Individual)	PSC BOX 20130 COMMANDING OFFICER, 2D DENBN/NDC 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1417518796	SHELBY ALLAN COMER (Individual)	COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208	Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National EMI Health Guardian Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	YES
1427735216	BLAKE LAWRENCE BOWMAN (Individual)	COMMANDING OFFICER, NAVAL HOSPITAL 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1427789940	ELIJAH JAMES CUTSHALL (Individual)	COMMANDING OFFICER 2D DENBN/NDC, PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1437841251	ALLAN AHMAD (Individual)	COMMANDING OFFICER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1437989654	JENIVEVE MYRE HOWARD TELLMANN (Individual)	COMMANDING OFFICER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1447043278	GABRIEL BROWN HUTCHESON (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-4357		Non-Participating Provider	NO
1457331092	WILLIAM P RIEGER (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-1658		Opted out of Medicare	YES
1457349649	KARLA IYONMAHAN (Individual)	MARINE CORPS BASE - CAMP LEJEUNE 460 BLDG JULIAN C. SMITH BLVD CAMP LEJEUNE, NC 28542 (910) 451-1013	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Companion Life Insurance Company Dominion National Florida Combined Life Paramount Paramount Dental	Non-Participating Provider	YES
1457877458	BENJAMIN ATLAS (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (760) 519-4801	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1467119545	NATALIE ANN NUCKOLLS (Individual)	700 MCHUGH BVLD HP 102 CAMP LEJEUNE, NC 28542 (910) 451-1658		Non-Participating Provider	NO
1467783241	BRADEN GREY MILLER (Individual)	2D DEN BN/NDC PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28540 (910) 451-2208	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana Premera Blue Cross Blue Shield of Alaska UnitedHealthcare	Non-Participating Provider	NO
1477755346	JOHN PATRICK WALSH (Individual)	315 MCHUGH BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1477841500	TYLER VOIGHT WURMLINGER (Individual)	2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD COMMANDING OFFICER CAMP LEJEUNE, NC 28542 (910) 451-2208	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1477942548	THAMAR ANSARI SARWAR (Individual)	2D DENTAL BATTALION HQ CAMP LEJEUNE, NC 28547 (910) 451-1658	Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of NC Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY WellCare of North Carolina	Non-Participating Provider	YES
1487003679	JOSHUA D BARCLAY (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (612) 624-7133		Non-Participating Provider	NO
1487358867	DANIEL C HUPP (Individual)	COMMANDING OFFICER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (214) 828-8215		Non-Participating Provider	NO
1497365134	LAYTON MIKKALSON (Individual)	COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208	Aetna CVS Health Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Florida Combined Life Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1497532428	SAMANTHA INGRID RUSTIA (Individual)	COMMANDING OFFICER, NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1497638506	AUSTIN DOUGLAS BROWNER (Individual)	COMMANDING OFFICER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1497734560	THOMAS ARTHUR LAFFERTY (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1518053974	MICHAEL FLEMING TRENT (Individual)	315 MCHUGH BLVD 2E DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1518392000	DAVID PARENT BURR (Individual)	315 MCHUGH BLVD COMMANDING OFFICER 2D DENBN/NDC, PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1548660566	ELI NATHAN LOWRY (Individual)	PSC 20130 315 MCHUGH BLVD COMMANDING OFFICER, 2D DENBN/NDC CAMP LEJEUNE, NC 28542 (910) 451-2208	Ambetter from Arkansas Health & Wellness Ambetter from Louisiana Healthcare Connections Ambetter from Magnolia Health Ambetter of Alabama Ambetter of Tennessee Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental PPO Florida Combined Life Guardian Humana Renaissance Dental	Non-Participating Provider	NO
1558347245	STEPHEN ALEXANDER YAMODIS (Individual)	2D DENTAL BATTALION NAVAL DENTAL CENTER CAMP LEJEUNE, NC 29405 (910) 451-2208	Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Dominion National Guardian Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1568862670	LAUREN DANIELLE GADEBERG (Individual)	2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD COMMANDING OFFICER CAMP LEJEUNE, NC 28542 (910) 451-2208	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Florida Combined Life Humana UnitedHealthcare	Non-Participating Provider	NO
1578543898	STUART O MILLER (Individual)	315 MCHUGH BLVD CAMP LEJEUNE, NC 28547 (910) 451-1013	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of North Carolina Florida Combined Life Guardian Humana UnitedHealthcare	Non-Participating Provider	YES
1578756458	MATTHEW AARON RUSSELL (Individual)	315 MCHUGH BLVD 2D DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208	Aetna CVS Health Ambetter from Arkansas Health & Wellness Ambetter from Home State Health Ambetter from Nebraska Total Care Ambetter from Sunflower Health Plan Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Ambetter of Oklahoma Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dentegra Insurance Company Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1588358246	TREVOR JAMES CHASE (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (520) 425-7451		Non-Participating Provider	NO
1588644462	TUANH CARSON HALQUIST (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (252) 466-0401		Non-Participating Provider	NO
1598177222	BLAKE AARON DONALDSON (Individual)	315 MCHUGH BLVD COMMANDING OFFICER 2D DENBN/NDC PSC 20130 CAMP LEJEUNE, NC 28540 (910) 451-2208		Non-Participating Provider	NO
1598379687	MARISSA T SINGH (Individual)	COMMANDING OFFICER 2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1598584856	JULIA LAURA SZURNICKI (Individual)	COMMANDING OFFICER, NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1609163229	JAREN THOMAS MAY (Individual)	BLDG HP-102 700 MCHUGH BLVD CAMP LEJEUNE, NC 28547 (910) 451-1658		Non-Participating Provider	NO
1609555804	TYLER AVERY OAKES (Individual)	700 MCHUGH BLVD BLDG HP 102 CAMP LEJEUNE, NC 28547 (910) 450-4740		Non-Participating Provider	NO
1629049986	WILLIAM CLAUDE BEUTEL (Individual)	100 BREWSTER BLVD NAVAL HOSPITAL CAMP LEJEUNE CAMP LEJEUNE, NC 28547 (910) 450-4136	Aetna CVS Health Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of NC Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of North Carolina Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1629058938	ROBERT ETHERIDGE (Individual)	315 MCHUGH BLVD 2D DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1649250663	DENNIS GREGORY SAMPSON (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/ NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208	Anthem Blue Cross and Blue Shield	Non-Participating Provider	NO
1649568908	CLIFFORD WILLIAM MOORE (Individual)	315 MCHUGH BLVD 2D DENBN/NDC COMMANDING OFFICER CAMP LEJEUNE, NC 28540 (910) 451-2208	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of Ohio Guardian Humana Renaissance Dental TRUASSURE INSURANCE COMPANY	Non-Participating Provider	YES
1669636981	BROOKE SIBILA STILES (Individual)	315 MCHUGH BLVD 2D DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of NC Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of North Carolina Guardian Paramount Paramount Dental	Non-Participating Provider	NO
1679026108	CASSANDRA DAVIS (Individual)	COMMANDING OFFICER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1679553424	DAVID LYNN HOBBS (Individual)	NAVAL HOSPITAL CAMP LEJEUNE, NC 28547 (910) 450-4740		Non-Participating Provider	NO
1689160947	WILLIAM THOMAS WATT (Individual)	COMMANDING OFFICER 2D DENBN/NDC, 315 MCHUGH BLVD PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of North Carolina	Non-Participating Provider	NO
1689459315	ALEX C PHAM (Individual)	NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1689654055	HOWARD C FLEISCHER (Individual)	315 MCHUGH BLVD 2D DENTAL BATALLION / NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1700919826	ADAM MICHAEL FIRESTONE (Individual)	315 MCHUGH BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208	Guardian	Non-Participating Provider	NO
1700971785	CATHERINE LOUISE CUMMINGS (Individual)	315 MCHUGH BLVD 2D DENBN/NDC CAMP LEJEUNE, NC 28547 (901) 451-2208		Non-Participating Provider	NO
1710120621	RYAN MATTHEW DAVIS (Individual)	2D DENBN/NDC 2DMLG PCS BOX 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208	Aetna CVS Health Ambetter from Meridian Ambetter Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of Ohio Dominion National Florida Combined Life Guardian Humana MedMutual Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	NO
1720690787	WILLIAM A WASHBURN (Individual)	COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1720808058	ASHLEY N REECE (Individual)	COMMANDING OFFICER, NAVAL MEDICAL CENTER 100 BREWSTERE BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1730381955	BRIAN MICHAEL GILLEN (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 415-5705	Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Delta Dental of North Carolina Florida Combined Life UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1730794439	LAUREN MARIE BARTON (Individual)	H M SMITH BLVD BLDG FC-308 CAMP LEJEUNE, NC 28542 (910) 451-5125	Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of NC Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of North Carolina Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	NO
1770058828	JORDAN ELIZABETH CROSS (Individual)	COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1770562860	ROBERT D. MAYNARD (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1770781304	WILLIAM J GEWAIN (Individual)	315 MCHUGH BLVD 2D DENBN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1790981298	ELISA MARIE ROTH (Individual)	100 BREWSTER BLVD NAVAL HOSPITAL CAMP LEJEUNE, NC 28547 (309) 349-2470	Guardian	Non-Participating Provider	NO
1811303183	KEVIN CHRISTOPHER WIMAN (Individual)	315 MCHUGH BLVD COMMANDING OFFICER, 2D DENBN/NDC, PSC 20130 CAMP LEJEUNE, NC 28542 (910) 451-2208	Aetna CVS Health Delta Dental UnitedHealthcare	Non-Participating Provider	YES
1811332331	CHRISTOPHER G MALIKEN (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-4740	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of NC Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Guardian Humana Paramount Paramount Dental Renaissance Dental	Opted out of Medicare	YES
1821752981	HANNAH MACKENZIE KIDD (Individual)	2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1831732825	CODY CLARK (Individual)	700 MCHUGH BLVD CAMP LEJEUNE, NC 28540 (910) 451-6122	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National EMI Health Guardian Humana Paramount Paramount Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare	Non-Participating Provider	YES
1841632270	ASHLEY BREWINGTON LOUDERMILK (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-4740	Delta Dental PPO DentaQuest USA Insurance Company Inc. Guardian Renaissance Dental	Non-Participating Provider	NO
1871383141	BRAWN GARY BAKER (Individual)	COMMANDING OFFICER NAVAL MEDICAL 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-6878		Non-Participating Provider	NO
1871567867	WILLIAM JOSEPH BURKE (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-4300	Aetna CVS Health Ambetter from Absolute Total Care Ambetter of North Carolina Ambetter of Tennessee Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of NC Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of North Carolina Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental TRUASSURE INSURANCE COMPANY UnitedHealthcare WellCare of North Carolina	Non-Participating Provider	YES
1881065456	KATHERINE A DECKER (Individual)	2D DENBN/NDC PSC 20130 315 MCHUGH BLVD COMMANDING OFFICER CAMP LEJEUNE, NC 28540 (910) 451-2208		Non-Participating Provider	NO
1891102992	MARYCATHERINE MCGINN MOHR (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (109) 450-4740		Non-Participating Provider	NO
1891515722	MACKENZIE GRACE VELK (Individual)	COMMANDING OFFICER, NAVAL MEDICAL CENTER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1891774279	RODNEY L. GUNNING (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION / NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1902796246	ZACHARY JAMES ESCHENBERG (Individual)	700 MCHUGH BLVD CAMP LEJEUNE, NC 28547 (910) 450-4740		Non-Participating Provider	NO
1942273396	JAY A BLACK (Individual)	315 MCHUGH BLVD 2D DEN BN/NDC CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO
1942275292	DANIEL EDWIN KIRKWOOD (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-4740	Blue Cross and Blue Shield of Alabama Delta Dental of North Carolina Florida Combined Life Humana TRUASSURE INSURANCE COMPANY UnitedHealthcare	Opted out of Medicare	YES
1952372047	CANDACE ALISON COLE (Individual)	315 MCHUGH BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of North Carolina Humana	Non-Participating Provider	YES
1952381402	DAVID SCOTT WELDON (Individual)	315 MCHUGH BLVD 2D DENTAL BATTALION/NAVAL DENTAL CENTER CAMP LEJEUNE, NC 28547 (910) 451-1658		Non-Participating Provider	NO
1962140517	WESLEY KYUHAN SON (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-4740		Non-Participating Provider	NO
1972279313	RYAN WILLIAM SEEHAFER (Individual)	2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208		Non-Participating Provider	NO
1992113757	MEGAN RENEE CARTER (Individual)	100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 450-4740		Non-Participating Provider	NO
1992357651	RYAN CARTER WAINWRIGHT (Individual)	COMMANDING OFFICER 2D DENBN/NDC PSC 20130 315 MCHUGH BLVD CAMP LEJEUNE, NC 28542 (910) 451-2208	Aetna CVS Health Ambetter from Home State Health Ambetter Health Ambetter Health of Delaware Ambetter of Illinois Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1992540868	SAVANNAH ANNE BUCHANAN (Individual)	COMMANDING OFFICER 100 BREWSTER BLVD CAMP LEJEUNE, NC 28547 (910) 451-2208		Non-Participating Provider	NO

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