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General NPI Number Information
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NPI Number | 1992616486
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Entity Type | Organization
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Legal Business Name | EASTMAN FAMILY DENTAL PC
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 5106 OAK ST
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City | EASTMAN
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State | GA
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Zip | 31023-6027
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Country | US
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Telephone | 478-242-6965
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Fax |
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Provider Business Mailing Address
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Address Line | 2557 MCPHERSON CHURCH RD
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City | DALLAS
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State | GA
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Zip | 30132-7139
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Country | US
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Telephone | 913-961-1270
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Fax |
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Authorized Official
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Title or Position | COO
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Name | CHRISTOPHER ZACHAREWICZ
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Credential |
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Telephone | 913-961-1270
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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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