Earnhardt, Charles E

Earnhardt, Charles E is an individual health care provider with primary practice located at 949 N 14Th St , Leesburg FL 34748-3838. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Earnhardt, Charles E can be contacted via phone (352) 460-0164.

Contact Information

Primary practice address
949 N 14Th St Leesburg FL 34748-3838
Phone: (352) 460-0164
Fax: (352) 460-0164
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X DN18116 Florida

Profile Details

NPI number 1992999023
LBN Legal business name Earnhardt, Charles E
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2007
Last updated Jan 26th, 2021 - 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 1992999023 NPPES
Florida MEDICAID 107915500

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