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General NPI Number Information
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NPI Number | 1689162620
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Entity Type | Organization
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Legal Business Name | ECONOMY DENTURES AND IMPLANTS
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 218 S 11TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-2810
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Country | US
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Telephone | 470-204-8184
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Fax | 470-204-8969
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Provider Business Mailing Address
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Address Line | 218 S 11TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-2810
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Country | US
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Telephone | 470-204-8184
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Fax | 470-204-8969
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. MARIANNA BOYD
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Credential |
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Telephone | 770-842-9325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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