Brent Depta is a Periodontics in Valdosta, Georgia. Brent Depta practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Brent Depta is 1649370339. The last update date is 2020-04-09.
Brent Depta's current location address is 2711 Windemere Dr, Valdosta, Georgia. You can contact this provider via phone number 2292470437 and fax number 2292424395. The mailing address for Brent Depta is 2711 Windemere Dr, Valdosta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brent Depta |
|---|---|
| Address | 2711 Windemere Dr, Valdosta, Georgia |
| Phone Number | 2292470437 |
| Fax Number | 2292424395 |
| Sole Proprietor | Y |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1649370339 |
|---|---|
| Provider Enumeration Date | 2006-09-23 |
| Last Updated Date | 2020-04-09 |
Provider Mailing Address Detail
| Address | 2711 Windemere Dr |
|---|---|
| City | Valdosta |
| State | Georgia (GA) |
| Post Code | 316021696 |
| Phone Number | 2292470437 |
| Fax Number | 2292424395 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 12319 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Post Comment/ Review Below
What is the Brent Depta's 1649370339?
The Brent Depta's NPI (National Provider Identifier) Number is 1649370339. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Brent Depta is geographically located?
The Brent Depta is physically situated at the following location: 2711 Windemere Dr, Valdosta, GA, 316021696.
What is the Brent Depta's specialty and taxonomy code?
The Brent Depta's specialty is Periodontics, and the corresponding taxonomy code is 1223P0300X.
On what date was the 1649370339 assigned to Brent Depta?
The Brent Depta was issued its 1649370339 on 2006-09-23, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Brent Depta, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Brent Depta, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-04-09.