Pridemore, Benjamin M
Pridemore, Benjamin M is an sole proprietor health care provider with primary practice located at 23 John Maddox Dr Nw , Rome GA 30165-1413. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Pridemore, Benjamin M can be contacted via phone (706) 234-0877.Contact Information
Primary practice address
23 John Maddox Dr Nw
Rome GA 30165-1413
Phone: (706) 234-0877
Fax: (706) 232-5327
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | DN007095 | Georgia |
Profile Details
NPI number | 1336153592 |
---|---|
LBN Legal business name | Pridemore, Benjamin M |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jul 27th, 2006 |
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 | 1336153592 | NPPES |
Georgia | Other | DN007095 | STATE LICENSE NUMBER |
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