| Kodak Family Dental, Pllc | |
|
2946 Winfield Dunn Pkwy Ste 301 Kodak TN 37764-4319 | |
| (865) 465-7058 | |
| Not Available |
| Full Name | Kodak Family Dental, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2946 Winfield Dunn Pkwy Ste 301, Kodak, Tennessee |
| Authorized Official Name and Position | Noelan Jurgen Schafer (OWNER) |
| Authorized Official Contact | 5099601744 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kodak Family Dental, Pllc 3428 Woodward Down Trl Buford GA 30519-5054 Ph: (509) 960-1744 | Kodak Family Dental, Pllc 2946 Winfield Dunn Pkwy Ste 301 Kodak TN 37764-4319 Ph: (865) 465-7058 |
| NPI Number | 1720692726 |
|---|---|
| Provider Enumeration Date | 09/07/2020 |
| Last Update Date | 09/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720692726 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Kodak Dental Care, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2946 Winfield Dunn Pkwy, Suite 301, Kodak, TN 37764 Phone: 865-465-7058 Fax: 865-465-3432 |