Bridgers, Shannitta Latrease
Bridgers, Shannitta Latrease is an individual health care provider with primary practice located at 1367 Walter Reed Rd Suite 103, Fayetteville NC 28304. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Bridgers, Shannitta Latrease can be contacted via phone (910) 485-8749.Contact Information
Primary practice address
1367 Walter Reed Rd Suite 103
Fayetteville NC 28304
Phone: (910) 485-8749
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 8568 | North Carolina |
Profile Details
| NPI number | 1083872915 |
|---|---|
| LBN Legal business name | Bridgers, Shannitta Latrease |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 28th, 2008 |
| Last updated | May 23rd, 2018 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083872915 | NPPES |
| North Carolina | MEDICAID | 5911135 |
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