Statesboro Children's Dental Center, Pc | |
1501 Brampton Ave Statesboro GA 30458-0856 | |
(912) 871-6197 | |
(912) 871-6203 |
Full Name | Statesboro Children's Dental Center, Pc |
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Speciality | Clinic/center - Dental |
Location | 1501 Brampton Ave, Statesboro, Georgia |
Authorized Official Name and Position | John L Wasdin (OWNER) |
Authorized Official Contact | 9128716197 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Statesboro Children's Dental Center, Pc 1501 Brampton Ave Statesboro GA 30458-0856 Ph: (912) 871-6197 | Statesboro Children's Dental Center, Pc 1501 Brampton Ave Statesboro GA 30458-0856 Ph: (912) 871-6197 |
NPI Number | 1831372119 |
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Provider Enumeration Date | 12/10/2007 |
Last Update Date | 12/10/2007 |
Identifier | Type | State | Issuer |
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1831372119 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | DN011889 (Georgia) | Primary |
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East Georgia Center For Oral & Facial Surgery Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1222 Brampton Ave, Statesboro, GA 30458 Phone: 912-764-5435 Fax: 912-764-9789 | |
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