| Valdosta Family Dentistry | |
|
2935 N Ashley St Suite 130 Valdosta GA 31602-1777 | |
| (229) 333-8484 | |
| Not Available |
| Full Name | Valdosta Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2935 N Ashley St, Valdosta, Georgia |
| Authorized Official Name and Position | Benjamin F Tanner (DENTIST) |
| Authorized Official Contact | 2293338484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valdosta Family Dentistry 2935 N Ashley St Suite 130 Valdosta GA 31602-1777 Ph: (229) 333-8484 | Valdosta Family Dentistry 2935 N Ashley St Suite 130 Valdosta GA 31602-1777 Ph: (229) 333-8484 |
| NPI Number | 1811138258 |
|---|---|
| Provider Enumeration Date | 03/16/2009 |
| Last Update Date | 03/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811138258 | NPI | - | NPPES |
| 827915201A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN013182 (Georgia) | Primary |
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