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NPI Code Detail

MEDICARE: ANDREA DAVIS WOOD DMD

MEDICARE:   ANDREA DAVIS WOOD  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN011029GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21429244OTHERGAUNITED CONCORDIA
3100759OTHERGAAVESIS
49180606OTHERGADENTAQUEST

General Provider Information

NPI Number : 1285745505
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA DAVIS WOOD DMD
Provider Business Mailing Address
First Line : 1316 BOAT ROCK RD SW
Second Line :
City : ATLANTA
State : GA
Zip : 30331-7316
Country : US
Telephone Number : 404-310-6548
Fax Number :
Provider Business Practice Location Address
First Line : 1536 EISENHOWER PKWY
Second Line :
City : MACON
State : GA
Zip : 31206-3130
Country : US
Telephone Number : 478-781-4333
Fax Number : 478-781-4331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 11/26/2020

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Directions to “ ANDREA DAVIS WOOD DMD” Practice Location

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