| Benjamin F. Tanner Ii Dmd Pc | |
|
114 Huxford St Homerville GA 31634-2357 | |
| (912) 487-5271 | |
| (912) 487-5271 |
| Full Name | Benjamin F. Tanner Ii Dmd Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 114 Huxford St, Homerville, Georgia |
| Authorized Official Name and Position | Landon K Grantham (OFFICE MANAGER) |
| Authorized Official Contact | 9124875271 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin F. Tanner Ii Dmd Pc 114 Huxford St Homerville GA 31634-2357 Ph: (912) 487-5271 | Benjamin F. Tanner Ii Dmd Pc 114 Huxford St Homerville GA 31634-2357 Ph: (912) 487-5271 |
| NPI Number | 1437475209 |
|---|---|
| Provider Enumeration Date | 04/19/2010 |
| Last Update Date | 04/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437475209 | NPI | - | NPPES |
| 827915201D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN013182 (Georgia) | Primary |
Mark S. Ritz D.d.s. P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 Huxford St, Homerville, GA 31634 Phone: 912-487-5271 Fax: 912-487-5724 |