MEDICARE: ELIZABETH CHECK D.D.S.

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	1223P0221X	Pediatric Dentistry	RESIDENCY PERMIT 665	FL
2	1223P0221X	Pediatric Dentistry	DN014372	GA

General Provider Information

NPI Number	:	1760634224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH CHECK D.D.S.

Provider Business Mailing Address
First Line	:	10 SPRINGFIELD CROSS
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31411-2131
Country	:	US
Telephone Number	:	912-547-2018
Fax Number	:

Provider Business Practice Location Address
First Line	:	1806 OVER LAKE DR SE
Second Line	:
City	:	CONYERS
State	:	GA
Zip	:	30013-1745
Country	:	US
Telephone Number	:	770-760-7900
Fax Number	:

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

Provider Enumeration Date	:	10/15/2008
Last Update Date	:	01/14/2019

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