| Lakeside Family Dentistry And Tmj, Pc | |
|
7270 N Lake Dr Ste 100 Columbus GA 31909-2764 | |
| (706) 323-6491 | |
| (706) 323-2671 |
| Full Name | Lakeside Family Dentistry And Tmj, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7270 N Lake Dr Ste 100, Columbus, Georgia |
| Authorized Official Name and Position | Phillip Shelby Tully (PRESIDENT) |
| Authorized Official Contact | 7063236491 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Family Dentistry And Tmj, Pc 7270 N Lake Dr Ste 100 Columbus GA 31909-2764 Ph: (706) 323-6491 | Lakeside Family Dentistry And Tmj, Pc 7270 N Lake Dr Ste 100 Columbus GA 31909-2764 Ph: (706) 323-6491 |
| NPI Number | 1396825667 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 09/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396825667 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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