Thomas, Theodore Brandon

Thomas, Theodore Brandon is an individual health care provider with primary practice located at 450 Mckoy Street , Clinton NC 28328-2844. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Thomas, Theodore Brandon can be contacted via phone (910) 592-6171.

Contact Information

Primary practice address
450 Mckoy Street Clinton NC 28328-2844
Phone: (910) 592-6171
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 4818 North Carolina

Profile Details

NPI number 1174627541
LBN Legal business name Thomas, Theodore Brandon
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2006
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174627541 NPPES
North Carolina MEDICAID 8998417

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