Braselton, J Allen

Braselton, J Allen is an individual health care provider with primary practice located at 1430 John Wesley Gilbert Drive , Augusta GA 30912-1001. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Braselton, J Allen can be contacted via phone (706) 721-2371.

Contact Information

Primary practice address
1430 John Wesley Gilbert Drive Augusta GA 30912-1001
Phone: (706) 721-2371
Fax: (706) 721-6778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DN0008257 Georgia

Profile Details

NPI number 1447203575
LBN Legal business name Braselton, J Allen
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2006
Last updated Mar 10th, 2021 - about 3 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 1447203575 NPPES
South Carolina MEDICAID ZG8257
South Carolina MEDICAID 00044734B

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