| Azalea City Family Dentistry | |
|
414 Pendleton Pl Valdosta GA 31602-2603 | |
| (229) 244-3700 | |
| (229) 247-0373 |
| Full Name | Azalea City Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 414 Pendleton Pl, Valdosta, Georgia |
| Authorized Official Name and Position | William W Broadfoot (CEO) |
| Authorized Official Contact | 2292443700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Azalea City Family Dentistry 414 Pendleton Pl Valdosta GA 31602-2603 Ph: (229) 244-3700 | Azalea City Family Dentistry 414 Pendleton Pl Valdosta GA 31602-2603 Ph: (229) 244-3700 |
| NPI Number | 1295978047 |
|---|---|
| Provider Enumeration Date | 04/09/2009 |
| Last Update Date | 04/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295978047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN007995 (Georgia) | Primary |
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