Broughton, Charlotte W
Broughton, Charlotte W is an individual health care provider with primary practice located at 140 Lockland Ave , Winston-Salem NC 27103-2709. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Broughton, Charlotte W can be contacted via phone (336) 722-7534.Contact Information
Primary practice address
140 Lockland Ave
Winston-Salem NC 27103-2709
Phone: (336) 722-7534
Fax: (336) 722-4518
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / General Practice | 1223G0001X | 7114 | North Carolina |
Profile Details
NPI number | 1366446205 |
---|---|
LBN Legal business name | Broughton, Charlotte W |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 9th, 2005 |
Last updated | Jul 8th, 2007 - about 17 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 | 1366446205 | NPPES |
North Carolina | MEDICAID | 899013K |
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