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
Phone: (770) 487-9797
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831229426 | NPPES |
| Georgia | Other | 58-1433916 | T.I.N |
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