=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376556167
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID ADAM BADGETT DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 TRADE ST
-----------------------------------------------------
City | TARBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27886
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-823-4238
-----------------------------------------------------
Fax | 252-641-4833
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1296
-----------------------------------------------------
City | TARBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27886
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-823-4238
-----------------------------------------------------
Fax | 252-641-4833
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 5867
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------