| Brooks Dental Associates | |
|
13762 Magnolia St Blakely GA 39823-1875 | |
| (229) 723-4111 | |
| (229) 723-6083 |
| Full Name | Brooks Dental Associates |
|---|---|
| Speciality | Dentist |
| Location | 13762 Magnolia St, Blakely, Georgia |
| Authorized Official Name and Position | Charles P Brooks (OWNER) |
| Authorized Official Contact | 2297234111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brooks Dental Associates Po Box 707 Blakely GA 39823-0707 Ph: (229) 723-4111 | Brooks Dental Associates 13762 Magnolia St Blakely GA 39823-1875 Ph: (229) 723-4111 |
| NPI Number | 1023301348 |
|---|---|
| Provider Enumeration Date | 05/19/2011 |
| Last Update Date | 05/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023301348 | NPI | - | NPPES |
| 203717975A | Medicaid | GA | |
| 00044789C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN007286 (Georgia) | Primary |
| 122300000X | Dentist | DN014123 (Georgia) | Secondary |
Brooks Dental Associates, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13762 Magnolia St, Blakely, GA 39823 Phone: 229-723-4111 Fax: 229-723-6083 |