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General NPI Number Information
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NPI Number | 1023476652
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Entity Type | Organization
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Legal Business Name | JOHN AND PAUL DENTISTRY, LLC
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 160 PIERCE AVE
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City | MACON
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State | GA
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Zip | 31204-2871
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Country | US
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Telephone | 478-743-0901
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Fax |
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Provider Business Mailing Address
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Address Line | 160 PIERCE AVE
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City | MACON
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State | GA
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Zip | 31204-2871
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Country | US
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Telephone | 478-743-0901
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TINA LOCHER
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Credential |
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Telephone | 478-743-0901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN007573
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN013328
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN013383
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN012737
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License Number State | GA
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