PEDIATRIC DENTISTRY OF CENTRAL GEORGIA - MACON LLC NPI 1073083127

NPI Information

PEDIATRIC DENTISTRY OF CENTRAL GEORGIA - MACON LLC is a pediatric dentistry dentist in Macon, GA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. PEDIATRIC DENTISTRY OF CENTRAL GEORGIA - MACON LLC NPI is 1073083127. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5437 BOWMAN RD STE 300
MACON, GA
ZIP 31210-575
Phone: (478) 333-3636

The provider's authorized official is Shannon Battle .
The authorized official title is Practice Manager and has the following contact phone number (478) 333-3636.

The CLIA number assigned to this NPI record is 11D2029556 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 12/3/2018 and was last updated on 12/3/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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