| Northwest Endodontic Specialists, P.c. | |
|
271 Heritage Walk Woodstock GA 30188-3876 | |
| (770) 924-0423 | |
| (770) 924-9222 |
| Full Name | Northwest Endodontic Specialists, P.c. |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 271 Heritage Walk, Woodstock, Georgia |
| Authorized Official Name and Position | Richardson Michael Odum (PRESIDENT) |
| Authorized Official Contact | 7709240423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Endodontic Specialists, P.c. 271 Heritage Walk Woodstock GA 30188-3876 Ph: (770) 924-0423 | Northwest Endodontic Specialists, P.c. 271 Heritage Walk Woodstock GA 30188-3876 Ph: (770) 924-0423 |
| NPI Number | 1801916069 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801916069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 10232, 10416 (Georgia) | Primary |
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