Broadhead, Maiko Daisy
Broadhead, Maiko Daisy is an individual health care provider with primary practice located at 319 W General Screven Way Ste H , Hinesville GA 31313-3065. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Broadhead, Maiko Daisy can be contacted via phone (912) 368-6881.Contact Information
Primary practice address
319 W General Screven Way Ste H
Hinesville GA 31313-3065
Phone: (912) 368-6881
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 013190 | Georgia |
Profile Details
| NPI number | 1922124478 |
|---|---|
| LBN Legal business name | Broadhead, Maiko Daisy |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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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