Eaton, Derek J

Eaton, Derek J is an individual health care provider with primary practice located at 660 Summit Crossing Pl Suite 303, Gastonia NC 28054-2104. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Pathology, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Eaton, Derek J can be contacted via phone (704) 865-0081.

Contact Information

Primary practice address
660 Summit Crossing Pl Suite 303 Gastonia NC 28054-2104
Phone: (704) 865-0081
Fax: (704) 865-6004
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Pathology 1223P0106X 4005 South Carolina
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 9225 North Carolina

Profile Details

NPI number 1477649432
LBN Legal business name Eaton, Derek J
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Sep 23rd, 2011 - about 15 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 1477649432 NPPES
South Carolina MEDICAID ZX4005

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