| Magnolia Roots Endodontics Llc | |
|
100 Blue Moon Xing Ste 103 Pooler GA 31322-9809 | |
| (239) 404-0691 | |
| Not Available |
| Full Name | Magnolia Roots Endodontics Llc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 100 Blue Moon Xing Ste 103, Pooler, Georgia |
| Authorized Official Name and Position | Carleen Burt Sells (OWNER) |
| Authorized Official Contact | 9127374044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Roots Endodontics Llc 118 Oakdene Rd Pooler GA 31322-9783 Ph: (239) 404-0691 | Magnolia Roots Endodontics Llc 100 Blue Moon Xing Ste 103 Pooler GA 31322-9809 Ph: (239) 404-0691 |
| NPI Number | 1598514960 |
|---|---|
| Provider Enumeration Date | 05/16/2024 |
| Last Update Date | 10/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598514960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
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