MEDICARE: TROY WOODWARD 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
1	1223G0001X	General Practice Dentistry	DN123193	GA

General Provider Information

NPI Number	:	1417638776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY WOODWARD DMD

Provider Business Mailing Address
First Line	:	901 E 66TH ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4509
Country	:	US
Telephone Number	:	912-303-8080
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 E 66TH ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4509
Country	:	US
Telephone Number	:	912-303-8080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2023
Last Update Date	:	07/28/2023

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