Childers, Dale A
Childers, Dale A is an individual health care provider with primary practice located at 2409 Robeson Street , Fayetteville NC 28305. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Childers, Dale A can be contacted via phone (910) 483-9546.Contact Information
Primary practice address
2409 Robeson Street
Fayetteville NC 28305
Phone: (910) 483-9546
Fax: (910) 483-8550
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 4973 | North Carolina |
Profile Details
| NPI number | 1730272402 |
|---|---|
| LBN Legal business name | Childers, Dale A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Jul 9th, 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 | 1730272402 | NPPES |
| North Carolina | MEDICAID | 8991553 | |
| North Carolina | Other | 467383 | |
| North Carolina | Other | 955715 | |
| North Carolina | MEDICAID | 890138F |
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