Southend Dentistry

LBN: Bradford L Picot, Dds, P.A.
Southend Dentistry is an health care organization with primary practice located at 1520 South Blvd Suite 110, Charlotte NC 28203-4786. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Managed Care Organizations / Health Maintenance Organization. Dental Providers / General Practice is the primary health care specialty. Bradford L Picot, Dds, P.A. can be contacted via phone (704) 335-8266, or through Picot, Bradford Lee via phone (704) 335-8266.

Contact Information

Primary practice address
1520 South Blvd Suite 110 Charlotte NC 28203-4786
Phone: (704) 335-8266
Fax: (704) 335-8267
Website:
Map and Directions
Authorized official contact:
Name: Picot, Bradford Lee Doctor of Dental Surgery (DDS)
Phone: (704) 335-8266

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 8158 North Carolina
Managed Care Organizations / Health Maintenance Organization 302R00000X 8158 North Carolina

Profile Details

NPI number 1003048752
LBN Legal business name Bradford L Picot, Dds, P.A.
DBA Doing business as Southend Dentistry
Authorized official Picot, Bradford Lee Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 13th, 2009
Last updated Aug 13th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003048752 NPPES
North Carolina MEDICAID 5908420

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