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General NPI Number Information
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NPI Number | 1215307442
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Entity Type | Organization
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Legal Business Name | DODD SURGICAL ASSISTING, LLC
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 09/30/2015
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Provider Practice Location Address
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Address Line | 234 WESTWIND DR
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City | BALL GROUND
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State | GA
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Zip | 30107-7722
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Country | US
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Telephone | 770-205-1233
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Fax | 770-205-0483
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Provider Business Mailing Address
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Address Line | 234 WESTWIND DR
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City | BALL GROUND
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State | GA
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Zip | 30107-7722
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Country | US
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Telephone | 770-205-1233
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Fax | 770-205-0483
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Authorized Official
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Title or Position | CERTIFIED SURGICAL ASSISTANT
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Name | MR. DAVID DEWEY DODD
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Credential | CSA
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Telephone | 770-205-1233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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