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General NPI Number Information
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NPI Number | 1376288308
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Entity Type | Organization
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Legal Business Name | SOUTHEASTERN DENTAL CENTER-COLUMBUS LLC
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 3650 GURLEY DR
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City | COLUMBUS
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State | GA
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Zip | 31904-5623
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Country | US
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Telephone | 706-571-0201
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Fax |
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Provider Business Mailing Address
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Address Line | 222 CHAMBLESS LN
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City | HAMILTON
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State | GA
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Zip | 31811-6144
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Country | US
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Telephone | 706-628-0011
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | STEVEN ALAN ARRINGTON
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Credential |
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Telephone | 706-628-0011
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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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