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100 Wesley Mountain Dr Blairsville GA 30512-8338 | |
| (706) 745-7100 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 100 Wesley Mountain Dr, Blairsville, Georgia |
| Authorized Official Name and Position | Jordana C Freitas (OWNER/ DENTIST) |
| Authorized Official Contact | 6786650178 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
100 Wesley Mountain Dr Blairsville GA 30512-8338 Ph: (706) 745-7100 | 100 Wesley Mountain Dr Blairsville GA 30512-8338 Ph: (706) 745-7100 |
| NPI Number | 1912767039 |
|---|---|
| Provider Enumeration Date | 03/19/2024 |
| Last Update Date | 03/29/2024 |
| Medicare PECOS PAC ID | 7719411784 |
|---|---|
| Medicare Enrollment ID | O20241113002385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912767039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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