Payne, Larry Jason
Payne, Larry Jason is an individual health care provider with primary practice located at 4965 Friendship Rd Suite 105, Buford GA 30518-1700. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Payne, Larry Jason can be contacted via phone (770) 614-7122.Contact Information
Primary practice address
4965 Friendship Rd Suite 105
Buford GA 30518-1700
Phone: (770) 614-7122
Fax: (770) 614-7211
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DN012442 | Georgia |
Profile Details
| NPI number | 1689795148 |
|---|---|
| LBN Legal business name | Payne, Larry Jason |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 3rd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689795148 | NPPES |
| Georgia | MEDICAID | 00940783B |
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