Heard, Kelwin J
Heard, Kelwin J is an individual health care provider with primary practice located at 4806 Flat Shoals Pkwy , Decatur GA 30034-5205. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Heard, Kelwin J can be contacted via phone (770) 987-3430.Contact Information
Primary practice address
4806 Flat Shoals Pkwy
Decatur GA 30034-5205
Phone: (770) 987-3430
Fax: (770) 987-7929
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DN011170 | Georgia |
Profile Details
| NPI number | 1902950777 |
|---|---|
| LBN Legal business name | Heard, Kelwin J |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1902950777 | NPPES |
| Georgia | MEDICAID | 00888643A |
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