| Providence Dental Spa Of Newnan, Llc | |
|
166 Jefferson Pkwy Newnan GA 30263-5822 | |
| (770) 252-1300 | |
| (770) 252-1763 |
| Full Name | Providence Dental Spa Of Newnan, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 166 Jefferson Pkwy, Newnan, Georgia |
| Authorized Official Name and Position | Paul Jason Mann (MANAGING PARTNER) |
| Authorized Official Contact | 7705507741 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Dental Spa Of Newnan, Llc 225 N Macon St Macon GA 31210-6562 Ph: (478) 733-0857 | Providence Dental Spa Of Newnan, Llc 166 Jefferson Pkwy Newnan GA 30263-5822 Ph: (770) 252-1300 |
| NPI Number | 1679231831 |
|---|---|
| Provider Enumeration Date | 12/06/2021 |
| Last Update Date | 12/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679231831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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