| Ingleside Dental Assoicates, P.c. | |
|
2440 Ingleside Ave Macon GA 31204-2088 | |
| (478) 743-3441 | |
| (478) 743-1542 |
| Full Name | Ingleside Dental Assoicates, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 2440 Ingleside Ave, Macon, Georgia |
| Authorized Official Name and Position | Jennifer Jackson Roberson (OWNER) |
| Authorized Official Contact | 4787433441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingleside Dental Assoicates, P.c. 2440 Ingleside Ave Macon GA 31204-2088 Ph: (478) 743-3441 | Ingleside Dental Assoicates, P.c. 2440 Ingleside Ave Macon GA 31204-2088 Ph: (478) 743-3441 |
| NPI Number | 1780712224 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780712224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 0200082 (Georgia) | Primary |
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