Jefferson Dental Care | |
1679 Old Pendergrass Rd Jefferson GA 30549-2705 | |
(770) 297-0401 | |
Not Available |
Full Name | Jefferson Dental Care |
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Speciality | Dentist |
Location | 1679 Old Pendergrass Rd, Jefferson, Georgia |
Authorized Official Name and Position | Tiffany Crowe (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 7702970401 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jefferson Dental Care 1679 Old Pendergrass Rd Jefferson GA 30549-2705 Ph: () - | Jefferson Dental Care 1679 Old Pendergrass Rd Jefferson GA 30549-2705 Ph: (770) 297-0401 |
NPI Number | 1366940884 |
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Provider Enumeration Date | 01/30/2018 |
Last Update Date | 01/30/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366940884 | NPI | - | NPPES |
1902238926 | Other | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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