| The Denture Place | |
|
175 Decatur Rd Suite B Mcdonough GA 30253-2024 | |
| (770) 957-1113 | |
| (770) 957-2182 |
| Full Name | The Denture Place |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 175 Decatur Rd, Mcdonough, Georgia |
| Authorized Official Name and Position | Earl Douglas Henson (OWNER) |
| Authorized Official Contact | 7709571113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Denture Place 175 Decatur Rd Suite B Mcdonough GA 30253-2024 Ph: (770) 957-1113 | The Denture Place 175 Decatur Rd Suite B Mcdonough GA 30253-2024 Ph: (770) 957-1113 |
| NPI Number | 1417283730 |
|---|---|
| Provider Enumeration Date | 10/21/2009 |
| Last Update Date | 10/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417283730 | NPI | - | NPPES |
| 0051664G | Medicaid | GA | |
| 312341163B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN007434 (Georgia) | Primary |
| 1223G0001X | Dentist - General Practice | DN013862 (Georgia) | Secondary |
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