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1714 E Broad Ave Albany GA 31705-2611 | |
| (229) 435-5176 | |
| (229) 435-0417 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1714 E Broad Ave, Albany, Georgia |
| Authorized Official Name and Position | Ronnie William Arrington (PRESIDENT) |
| Authorized Official Contact | 2294355176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 3821 Albany GA 31706-3821 Ph: (229) 435-5176 | 1714 E Broad Ave Albany GA 31705-2611 Ph: (229) 435-5176 |
| NPI Number | 1932126836 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932126836 | NPI | - | NPPES |
| 000255428B | Medicaid | GA | |
| 000255428A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9325 (Georgia) | Primary |
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