| Advanced Dental Arts, Llc | |
|
4705 Northside Dr Suite 100 Macon GA 31210-1698 | |
| (478) 207-6939 | |
| (478) 254-9638 |
| Full Name | Advanced Dental Arts, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4705 Northside Dr, Macon, Georgia |
| Authorized Official Name and Position | Samer Mufid Othman (OWNER) |
| Authorized Official Contact | 4782076939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Arts, Llc 4705 Northside Dr Suite 100 Macon GA 31210-1698 Ph: (478) 207-6939 | Advanced Dental Arts, Llc 4705 Northside Dr Suite 100 Macon GA 31210-1698 Ph: (478) 207-6939 |
| NPI Number | 1679969380 |
|---|---|
| Provider Enumeration Date | 04/09/2015 |
| Last Update Date | 04/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679969380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN014686 (Georgia) | Primary |
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