Faircloth, David Neal

Faircloth, David Neal is an individual health care provider with primary practice located at 1222 George C Wilson Dr , Augusta GA 30909-4502. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Faircloth, David Neal can be contacted via phone (706) 868-9500.

Contact Information

Primary practice address
1222 George C Wilson Dr Augusta GA 30909-4502
Phone: (706) 868-9500
Fax: (706) 868-5081
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 10995 Georgia
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 3369 South Carolina

Profile Details

NPI number 1669404307
LBN Legal business name Faircloth, David Neal
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Jan 21st, 2008 - about 16 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 1669404307 NPPES
Georgia Other GRP5093 MEDICARE GA GROUP
Georgia MEDICAID Z33697 MEDICARE GA GROUP
Georgia Other 7561 MEDICARE GA GROUP
Georgia MEDICAID 00707396B MEDICARE GA GROUP

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