Caswell, Charisse L.

Caswell, Charisse L. is an individual health care provider with primary practice located at 120 Handley Rd Suite 210, Tyrone GA 30290-2177. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Caswell, Charisse L. can be contacted via phone (770) 632-7090.

Contact Information

Primary practice address
120 Handley Rd Suite 210 Tyrone GA 30290-2177
Phone: (770) 632-7090
Fax: (770) 632-7075
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN013163 Georgia
Dental Providers / Pediatric Dentistry 1223P0221X DN013163 Georgia

Profile Details

NPI number 1326013921
LBN Legal business name Caswell, Charisse L.
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Mar 10th, 2016 - about 9 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 1326013921 NPPES
Georgia MEDICAID 773054619G
Georgia MEDICAID 773054619H

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