| Howard D Booth Jr Dds | |
|
250 Charter Ln Suite G2 Macon GA 31210-4594 | |
| (478) 471-8103 | |
| (478) 471-9186 |
| Full Name | Howard D Booth Jr Dds |
|---|---|
| Speciality | Clinic/Center |
| Location | 250 Charter Ln, Macon, Georgia |
| Authorized Official Name and Position | Howard Douglas Booth (OWNER) |
| Authorized Official Contact | 4784718103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Howard D Booth Jr Dds 250 Charter Ln Suite G2 Macon GA 31210-4594 Ph: (478) 471-8103 | Howard D Booth Jr Dds 250 Charter Ln Suite G2 Macon GA 31210-4594 Ph: (478) 471-8103 |
| NPI Number | 1568867851 |
|---|---|
| Provider Enumeration Date | 10/29/2014 |
| Last Update Date | 10/29/2014 |
| Medicare PECOS PAC ID | 9436464617 |
|---|---|
| Medicare Enrollment ID | O20150817002910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568867851 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 8838 (Georgia) | Primary |
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