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NPI Code Detail

MEDICARE: JAMES T MAHOLICK DMD

MEDICARE: JAMES T MAHOLICK DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistGADN012555GA

General Provider Information

NPI Number : 1568536522
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMES T MAHOLICK DMD
Provider Business Mailing Address
First Line : 3081 WILLIAMS ROAD
Second Line : UNIT B - 100
City : COLUMBUS
State : GA
Zip : 31909
Country : US
Telephone Number : 706-494-1200
Fax Number : 706-494-1333
Provider Business Practice Location Address
First Line : 3081 WILLIAMS ROAD
Second Line : UNIT B - 100
City : COLUMBUS
State : GA
Zip : 31909
Country : US
Telephone Number : 706-494-1200
Fax Number : 706-494-1333
Authorized Official
Title or Position : OWNER / DENTIST
Name : MR. JAMES THOMAS MAHOLICK
Credential : DMD
Telephone Number : 706-494-1200
Provider Enumeration Date : 11/20/2006
Last Update Date : 05/14/2021

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