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General NPI Number Information
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NPI Number | 1376662254
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Entity Type | Organization
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Legal Business Name | GLOVER DENTAL CENTRE' LLC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2607 GILLIONVILLE RD
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City | ALBANY
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State | GA
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Zip | 31707-3003
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Country | US
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Telephone | 229-883-3443
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Fax | 229-883-6755
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Provider Business Mailing Address
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Address Line | 2607 GILLIONVILLE RD
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City | ALBANY
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State | GA
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Zip | 31707-3003
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Country | US
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Telephone | 229-883-3443
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Fax | 229-883-6755
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Authorized Official
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Title or Position | OWNER
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Name | DR. SONYA S. TAYLOR-GLOVER
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Credential | DMD
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Telephone | 229-883-3443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 011294
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License Number State | GA
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