Pruett, Michael Edward

Pruett, Michael Edward is an individual health care provider with primary practice located at 1430 John Wesley Gilbert Drive , Augusta GA 30912-0001. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Pruett, Michael Edward can be contacted via phone (706) 721-4025.

Contact Information

Primary practice address
1430 John Wesley Gilbert Drive Augusta GA 30912-0001
Fax: (706) 723-0266
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DNCS000131 Georgia
Dental Providers / General Practice 1223G0001X DN011110 Georgia

Profile Details

NPI number 1669427837
LBN Legal business name Pruett, Michael Edward
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Apr 13th, 2023 - about last year

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 1669427837 NPPES
South Carolina MEDICAID ZG1110
South Carolina MEDICAID 00812523C

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