Dickerson, Christopher Bradley

Dickerson, Christopher Bradley is an individual health care provider with primary practice located at 363 Lakeview Ct , Covington LA 70433-7515. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Dickerson, Christopher Bradley can be contacted via phone (985) 641-2030.

Contact Information

Primary practice address
363 Lakeview Ct Covington LA 70433-7515
Phone: (985) 641-2030
Fax: (985) 900-2189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 5714 Louisiana

Profile Details

NPI number 1629242896
LBN Legal business name Dickerson, Christopher Bradley
Credentials DDS, MD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2008
Last updated Jun 15th, 2020 - about 4 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 1629242896 NPPES
Louisiana MEDICAID 29783

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