| Family Practice Dental Care Of Statesboro | |
|
1046 Northside Dr E Statesboro GA 30458-1002 | |
| (912) 764-9187 | |
| (912) 764-7530 |
| Full Name | Family Practice Dental Care Of Statesboro |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1046 Northside Dr E, Statesboro, Georgia |
| Authorized Official Name and Position | Dale Cyril Madson (OWNER) |
| Authorized Official Contact | 9127649187 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice Dental Care Of Statesboro 1046 Northside Dr E Statesboro GA 30458-1002 Ph: (912) 764-9187 | Family Practice Dental Care Of Statesboro 1046 Northside Dr E Statesboro GA 30458-1002 Ph: (912) 764-9187 |
| NPI Number | 1558562074 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 10/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558562074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8617 (Georgia) | Primary |
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