Healthcare Provider Details

I. General information

NPI: 1346078797
Provider Name (Legal Business Name): BRITANNY TAIT RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2024
Last Update Date: 07/25/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TURNER ELEMENTARY SCHOOL BASED HEALTH CENTER 2001 LEONARD AVE.
ALBANY GA
31705
US

IV. Provider business mailing address

204 N. WESTOVER BLVD.
ALBANY GA
31707
US

V. Phone/Fax

Practice location:
  • Phone: 229-435-9934
  • Fax: 209-888-1432
Mailing address:
  • Phone: 229-405-6249
  • Fax: 229-329-4373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH012822
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: