MACON PERIODONTICS AND IMPLANT DENTISTRY LLC NPI 1457606881

NPI Information

MACON PERIODONTICS AND IMPLANT DENTISTRY, LLC is a periodontics dentist in Macon, GA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. MACON PERIODONTICS AND IMPLANT DENTISTRY, LLC NPI is 1457606881. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1923 HARDEMAN AVE
MACON, GA
ZIP 31201-162
Phone: (478) 742-4254
Fax: (478) 742-1457

The provider's authorized official is Kay Willis .
The authorized official title is Business Coordinator and has the following contact phone number (478) 742-4254.

The enumeration date for this NPI number is 7/23/2012 and was last updated on 7/23/2012.

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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