Graddy, Nathan Alphonso
Graddy, Nathan Alphonso is an sole proprietor health care provider with primary practice located at 9721 Us Highway 19 , Port Richey FL 34668-7503. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Graddy, Nathan Alphonso can be contacted via phone (727) 846-7555.Contact Information
Primary practice address
9721 Us Highway 19
Port Richey FL 34668-7503
Phone: (727) 846-7555
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN4964 | Florida |
Profile Details
| NPI number | 1225318025 |
|---|---|
| LBN Legal business name | Graddy, Nathan Alphonso |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 24th, 2011 |
| Last updated | Dec 27th, 2019 - about 6 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 | 1225318025 | NPPES |
| Florida | MEDICAID | 072704100 |
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