Shepard, Keith E
Shepard, Keith E is an sole proprietor health care provider with primary practice located at 705 Windy Hill Rd Se , Smyrna GA 30080-1854. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Shepard, Keith E can be contacted via phone (770) 801-1641.Contact Information
Primary practice address
705 Windy Hill Rd Se
Smyrna GA 30080-1854
Phone: (770) 801-1641
Fax: (770) 801-0587
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DN014208 | Georgia |
Profile Details
| NPI number | 1386855880 |
|---|---|
| LBN Legal business name | Shepard, Keith E |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 25th, 2007 |
| Last updated | Jul 26th, 2013 - about 12 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 | 1386855880 | NPPES |
| Georgia | MEDICAID | 003122728B |
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