| Youth Dentistry Of Macon, Pc | |
|
1536 Eisenhower Pkwy Macon GA 31206-3130 | |
| (478) 781-4333 | |
| (478) 781-4331 |
| Full Name | Youth Dentistry Of Macon, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1536 Eisenhower Pkwy, Macon, Georgia |
| Authorized Official Name and Position | Linda S Zoeller (VP, LEGAL LICENSING & CREDENTIALING) |
| Authorized Official Contact | 4787814333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Dentistry Of Macon, Pc 1536 Eisenhower Pkwy Macon GA 31206-3130 Ph: (478) 781-4333 | Youth Dentistry Of Macon, Pc 1536 Eisenhower Pkwy Macon GA 31206-3130 Ph: (478) 781-4333 |
| NPI Number | 1851366462 |
|---|---|
| Provider Enumeration Date | 02/18/2006 |
| Last Update Date | 09/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851366462 | NPI | - | NPPES |
| 1905601 | Other | GA | UNITED CONCORDIA |
| 478300670A | Medicaid | GA | |
| 539109 | Other | GA | AVESIS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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