MEDICARE: HEATH WILLIAM BRACE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	11114	SC

General Provider Information

NPI Number	:	1205722709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATH WILLIAM BRACE DMD

Provider Business Mailing Address
First Line	:	WOMACK ARMY MEDICAL CENTER 2817 ROCK MERRIT AVE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	WOMACK ARMY MEDICAL CENTER 2817 ROCK MERRITT AVE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-8934
Country	:	US
Telephone Number	:	706-691-1702
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2025
Last Update Date	:	03/03/2026

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