Omalee Dental Llc | |
14 Sixth Ave Omaha GA 31821 | |
(229) 838-4203 | |
(229) 838-4204 |
Full Name | Omalee Dental Llc |
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Speciality | Clinic/center - Dental |
Location | 14 Sixth Ave, Omaha, Georgia |
Authorized Official Name and Position | Robert E Lee (OWNER) |
Authorized Official Contact | 2298384203 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Omalee Dental Llc 14 Sixth Ave Box 200 Omaha GA 31821 Ph: (229) 838-4203 | Omalee Dental Llc 14 Sixth Ave Omaha GA 31821 Ph: (229) 838-4203 |
NPI Number | 1831326826 |
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Provider Enumeration Date | 06/17/2009 |
Last Update Date | 06/17/2009 |
Identifier | Type | State | Issuer |
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1831326826 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | DN010226 (Georgia) | Primary |