| Marsha Jordan Holloway, Llc | |
|
1525 Baytree Rd Suite I Valdosta GA 31602-2786 | |
| (229) 293-1360 | |
| (229) 293-1356 |
| Full Name | Marsha Jordan Holloway, Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1525 Baytree Rd, Valdosta, Georgia |
| Authorized Official Name and Position | Amanda Cooper (INSURANCE COORDINATOR) |
| Authorized Official Contact | 2292931360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marsha Jordan Holloway, Llc 1525 Baytree Rd Suite I Valdosta GA 31602-2786 Ph: (229) 293-1360 | Marsha Jordan Holloway, Llc 1525 Baytree Rd Suite I Valdosta GA 31602-2786 Ph: (229) 293-1360 |
| NPI Number | 1316096431 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316096431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 010688 (Georgia) | Primary |
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