Senoia Family Dentistry, Llc | |
42 Main St Suite 3b Senoia GA 30276-1889 | |
(770) 599-4441 | |
(770) 599-4442 |
Full Name | Senoia Family Dentistry, Llc |
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Speciality | Dentist - General Practice |
Location | 42 Main St, Senoia, Georgia |
Authorized Official Name and Position | Ragan Faler (OWNER) |
Authorized Official Contact | 6782890382 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Senoia Family Dentistry, Llc 42 Main St Suite 3b Senoia GA 30276-1889 Ph: (770) 599-4441 | Senoia Family Dentistry, Llc 42 Main St Suite 3b Senoia GA 30276-1889 Ph: (770) 599-4441 |
NPI Number | 1861736514 |
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Provider Enumeration Date | 11/19/2012 |
Last Update Date | 11/19/2012 |
Identifier | Type | State | Issuer |
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1861736514 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | DN012740 (Georgia) | Primary |
1223P0300X | Dentist - Periodontics | DN012726 (Georgia) | Secondary |