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Active NPI 1730214735 Organization (Entity Type 2)

Tracy E. Durham Dds Pc

Dentist - General Practice • Pooler, GA

About Tracy E. Durham Dds Pc NPI 1730214735 Summary

Tracy E. Durham Dds Pc is a verified healthcare organization specializing in Dentist - General Practice operating in Pooler, GA. Located at 145 TRADERS WAY, SUITE D, this facility provides patient care and medical services under National Provider Identifier (NPI) 1730214735.

Administrative operations and authorized compliance are overseen by Tracy Durham (President).

The facility is associated with 3 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

145 Traders Way
Suite D

Pooler, GA 313226005

Telephone 9127484494

Authorized Official Information

Authorized Contact Name

DR. Tracy Durham , D.D.S.

Title / Role

President

Official Telephone

9127484494

Facility Classifications & Specialties

Dentist - General Practice Primary Taxonomy

NUCC Taxonomy Code: 1223G0001X

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

3 Linked

Dentist - General Practice

Pooler, GA

View Practitioner Profile →

Dentist - General Practice

Pooler, GA

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 145 TRADERS WAY, SUITE D, POOLER, GA 313226005 (Tel: 9127484494)

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Updated Business Mailing Address July 08, 2007

Registered at 145 TRADERS WAY, SUITE D, POOLER, GA 313226005 (Tel: 9127484494)

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Organization / Clinic Name Updated July 08, 2007

Operating as TRACY E. DURHAM DDS PC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #DN011541 in GA)

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Initial NPI Registration & Enumeration February 22, 2007

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1730214735
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: February 22, 2007
Last Update: August 22, 2020

Mailing Address

145 Traders Way, Suite D

Pooler, GA 313226005

Phone: 9127484494

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.