Provider Demographics
NPI:1376556167
Name:BADGETT, DAVID ADAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ADAM
Last Name:BADGETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1296
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886
Mailing Address - Country:US
Mailing Address - Phone:252-823-4238
Mailing Address - Fax:252-641-4833
Practice Address - Street 1:211 TRADE ST
Practice Address - Street 2:
Practice Address - City:TARBORO
Practice Address - State:NC
Practice Address - Zip Code:27886
Practice Address - Country:US
Practice Address - Phone:252-823-4238
Practice Address - Fax:252-641-4833
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5867122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8990324Medicaid
NC90324OtherBCBS