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General NPI Number Information
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NPI Number | 1568536522
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Entity Type | Organization
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Legal Business Name | JAMES T MAHOLICK DMD
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 3081 WILLIAMS ROAD UNIT B - 100
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City | COLUMBUS
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State | GA
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Zip | 31909
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Country | US
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Telephone | 706-494-1200
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Fax | 706-494-1333
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Provider Business Mailing Address
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Address Line | 3081 WILLIAMS ROAD UNIT B - 100
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City | COLUMBUS
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State | GA
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Zip | 31909
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Country | US
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Telephone | 706-494-1200
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Fax | 706-494-1333
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | MR. JAMES THOMAS MAHOLICK
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Credential | DMD
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Telephone | 706-494-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | GADN012555
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License Number State | GA
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