Smith, Debra Bradfield
Smith, Debra Bradfield is an individual health care provider with primary practice located at 1121 Plaza Ave , Eastman GA 31023-6761. She recently has only one registered license in Dental Providers / Dental Public Health, which is considered as her primary health care specialty. Smith, Debra Bradfield can be contacted via phone (478) 374-5576.Contact Information
Primary practice address
1121 Plaza Ave
Eastman GA 31023-6761
Phone: (478) 374-5576
Fax: (478) 374-0234
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Public Health | 1223D0001X | 10003 | Georgia |
Profile Details
| NPI number | 1578555157 |
|---|---|
| LBN Legal business name | Smith, Debra Bradfield |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2005 |
| 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 | 1578555157 | NPPES |
| Georgia | MEDICAID | 00297932A | |
| Georgia | MEDICAID | 00297932B |
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