Tant, Bethany K
Tant, Bethany K is an individual health care provider with primary practice located at 3160 Henderson Dr , Jacksonville NC 28546-5248. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Tant, Bethany K can be contacted via phone (910) 346-5600.Contact Information
Primary practice address
3160 Henderson Dr
Jacksonville NC 28546-5248
Phone: (910) 346-5600
Fax: (910) 346-5396
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 7813 | North Carolina |
Profile Details
| NPI number | 1588644611 |
|---|---|
| LBN Legal business name | Tant, Bethany K |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2006 |
| Last updated | Jul 2nd, 2015 - about 9 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 | 1588644611 | NPPES |
| North Carolina | Other | 2060755 | UCCI |
| North Carolina | MEDICAID | 5908945 | UCCI |
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