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General NPI Number Information
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NPI Number | 1275687642
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Entity Type | Organization
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Legal Business Name | EFFINGHAM DENTAL ASSOCIATES,P.C.
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 105 S LAUREL ST
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City | SPRINGFIELD
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State | GA
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Zip | 31329-9255
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Country | US
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Telephone | 912-754-6822
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Fax | 912-754-4368
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Provider Business Mailing Address
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Address Line | PO BOX 517 105 SOUTH LAUREL ST.
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City | SPRINGFIELD
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State | GA
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Zip | 31329-0517
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Country | US
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Telephone | 912-754-6822
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Fax | 912-754-4368
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. VELMA R. NEASE
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Credential |
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Telephone | 912-754-6822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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