Durant, Tracy L

Durant, Tracy L is an sole proprietor health care provider with primary practice located at 1125 N Anderson Rd Suite 104, Rock Hill SC 29730-2776. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Durant, Tracy L can be contacted via phone (803) 325-8178.

Contact Information

Primary practice address
1125 N Anderson Rd Suite 104 Rock Hill SC 29730-2776
Fax: (803) 325-8179
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 3506 South Carolina

Profile Details

NPI number 1669683173
LBN Legal business name Durant, Tracy L
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 25th, 2007
Last updated Oct 10th, 2012 - about 14 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 1669683173 NPPES
South Carolina MEDICAID ZA9577
South Carolina Other 710905114

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