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
Fax: (336) 722-4518
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366446205 NPPES
North Carolina MEDICAID 899013K

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