Pittman, Bobby Teron
Pittman, Bobby Teron is an individual health care provider with primary practice located at 4458 Jonesboro Rd , Forest Park GA 30297-4314. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Pittman, Bobby Teron can be contacted via phone (678) 904-5665.Contact Information
Primary practice address
4458 Jonesboro Rd
Forest Park GA 30297-4314
Phone: (678) 904-5665
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DN013164 | Georgia |
Profile Details
| NPI number | 1154498145 |
|---|---|
| LBN Legal business name | Pittman, Bobby Teron |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 29th, 2006 |
| Last updated | Jun 18th, 2014 - about 10 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 | 1154498145 | NPPES |
| Georgia | MEDICAID | 652095315F |
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