Payne, Traci Michelle

Payne, Traci Michelle is an individual health care provider with primary practice located at 300 W Broadway Suite 6, Council Bluffs IA 51503-9078. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Payne, Traci Michelle can be contacted via phone (712) 256-9151.

Contact Information

Primary practice address
300 W Broadway Suite 6 Council Bluffs IA 51503-9078
Phone: (712) 256-9151
Fax: (712) 325-0288
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 03217 Iowa

Profile Details

NPI number 1336383207
LBN Legal business name Payne, Traci Michelle
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2009
Last updated Apr 23rd, 2009 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336383207 NPPES
Iowa MEDICAID 0188946
Iowa Other 1114906906

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