Brackett, Cassandra Griffith

Brackett, Cassandra Griffith is an sole proprietor health care provider with primary practice located at 3300 Memorial Dr Suite D-3, Decatur GA 30032-2700. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Oral and Maxillofacial Radiology. Dental Providers / Oral and Maxillofacial Radiology is her primary health care specialty. Brackett, Cassandra Griffith can be contacted via phone (404) 289-3060.

Contact Information

Primary practice address
3300 Memorial Dr Suite D-3 Decatur GA 30032-2700
Fax: (404) 288-6080
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 0010117 Georgia
Dental Providers / Oral and Maxillofacial Radiology 1223X0008X 010117 Georgia

Profile Details

NPI number 1033244124
LBN Legal business name Brackett, Cassandra Griffith
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2007
Last updated Mar 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033244124 NPPES
Georgia MEDICAID 000310318C

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