Prof Corp | |
500 N Lewis St Metter GA 30439 | |
(912) 685-2100 | |
(912) 685-6915 |
Full Name | Prof Corp |
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Speciality | Dentist - General Practice |
Location | 500 N Lewis St, Metter, Georgia |
Authorized Official Name and Position | William Wesley Clance (CEO) |
Authorized Official Contact | 9126852100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Prof Corp Po Box 718 Metter GA 30439 Ph: (912) 685-2100 | Prof Corp 500 N Lewis St Metter GA 30439 Ph: (912) 685-2100 |
NPI Number | 1407963853 |
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Provider Enumeration Date | 08/23/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407963853 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 9149 (Georgia) | Primary |