Fagundes, David Keith

Fagundes, David Keith is an individual health care provider with primary practice located at 105 Parker Dr Suite A, Lagrange GA 30240-6436. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Fagundes, David Keith can be contacted via phone (706) 884-3636.

Contact Information

Primary practice address
105 Parker Dr Suite A Lagrange GA 30240-6436
Phone: (706) 884-3636
Fax: (706) 884-8490
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 4564 Alabama
Dental Providers / Endodontics 1223E0200X 11435 Georgia

Profile Details

NPI number 1184701815
LBN Legal business name Fagundes, David Keith
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated May 7th, 2020 - about 5 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 1184701815 NPPES
Other 971792 UNITED CONCORDIA INSURANC

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