Richardson, Edwin M

Richardson, Edwin M is an sole proprietor health care provider with primary practice located at 113 Ebenezer Rd Suite 101, Fayetteville GA 30215-4816. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Richardson, Edwin M can be contacted via phone (770) 487-9797.

Contact Information

Primary practice address
113 Ebenezer Rd Suite 101 Fayetteville GA 30215-4816
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 10241 Georgia

Profile Details

NPI number 1831229426
LBN Legal business name Richardson, Edwin M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 6th, 2007
Last updated Jul 8th, 2007 - about 18 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 1831229426 NPPES
Georgia Other 58-1433916 T.I.N

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