Higginbotham, Bradley David
Higginbotham, Bradley David is an sole proprietor health care provider with primary practice located at 200 S 29Th St , Council Bluffs IA 51501-3449. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Higginbotham, Bradley David can be contacted via phone (712) 323-5801.Contact Information
Primary practice address
200 S 29Th St
Council Bluffs IA 51501-3449
Phone: (712) 323-5801
Fax: (712) 388-0553
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 6788 | Iowa |
Profile Details
| NPI number | 1437235728 |
|---|---|
| LBN Legal business name | Higginbotham, Bradley David |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1437235728 | NPPES |
| Iowa | MEDICAID | 0196410 |
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