Healthcare Provider Details

I. General information

NPI: 1013255132
Provider Name (Legal Business Name): DALTON PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2013
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W WAUGH ST
DALTON GA
30720-3143
US

IV. Provider business mailing address

PO BOX 799
WHITE SPRINGS FL
32096-0799
US

V. Phone/Fax

Practice location:
  • Phone: 706-876-4023
  • Fax:
Mailing address:
  • Phone: 386-884-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: JOHN L VASSAR
Title or Position: BILLING ADMINISTRATOR
Credential:
Phone: 386-884-9900