Ware Hardyn Eubank, DMD
Individual provider Active NPI Dentist · Clarkesville, GA
NPI 1902018062 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1902018062
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 011394 (GA)
- Practice address
- 107 Sherwood Dr
Clarkesville, GA 30523-4717 - Phone
- (706) 754-7433
- Fax
- (706) 754-1963
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011394 | GA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 011394 | GA | Yes |
Addresses
Primary practice location
107 Sherwood Dr
Clarkesville, GA 30523-4717
Mailing address
107 Sherwood Dr
P.O. Box 1926
Clarkesville, GA 30523-4717
Phone (706) 754-7433
Other providers in Clarkesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.