| Bremen Dental Depot Llc | |
|
302 Laurel St Bremen GA 30110-2124 | |
| (770) 537-4439 | |
| (770) 537-3708 |
| Full Name | Bremen Dental Depot Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 302 Laurel St, Bremen, Georgia |
| Authorized Official Name and Position | Stephen J Blank (OWNER) |
| Authorized Official Contact | 6788224714 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bremen Dental Depot Llc 302 Laurel St Bremen GA 30110-2124 Ph: (770) 537-4439 | Bremen Dental Depot Llc 302 Laurel St Bremen GA 30110-2124 Ph: (770) 537-4439 |
| NPI Number | 1487173217 |
|---|---|
| Provider Enumeration Date | 09/13/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487173217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Eric S. Leithner, Dmd, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Valley Run Dr., Bremen, GA 30110 Phone: 770-537-9656 |