PROVIDENCE DENTAL LLC

MACON, GA
NPI1295189595
Entity TypeOrganization
Authorized ContactPAUL JASON MANN
Owner
478-733-0857
Organization Subpart ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: GA  DN013536)
Enumeration Date2016-04-22
Last Update Date2016-04-22
Business Address
PROVIDENCE DENTAL LLC
225 N MACON ST
MACON, GA 31210-6562
Phone number: 478-733-0857
Mailing Address
PROVIDENCE DENTAL LLC
225 N MACON ST
MACON, GA 31210-6562
Phone number: 478-733-0857