is a Orthodontics And Dentofacial Orthopedics in Savannah, Georgia. practices all healthcare services and medical treatments related to Orthodontics And Dentofacial Orthopedics. The NPI Number for is 1821207374. The last update date is .
's current location address is 5102 Paulsen St Bldg 8, Savannah, Georgia. You can contact this provider via phone number 9126558855 and fax number 9123353416. The mailing address for is 5102 Paulsen St Bldg 8, Savannah, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 5102 Paulsen St Bldg 8, Savannah, Georgia |
| Phone Number | 9126558855 |
| Fax Number | 9123353416 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1821207374 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 5102 Paulsen St Bldg 8 |
|---|---|
| City | Savannah |
| State | Georgia (GA) |
| Post Code | 314054624 |
| Phone Number | 9126558855 |
| Fax Number | 9123353416 |
Provider's Primary Taxonomy Detail
| Speciality | Orthodontics And Dentofacial Orthopedics |
|---|---|
| Taxonomy | 1223X0400X |
| Licence No | GADN008086 |
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Definition: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their rel |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 274736629 | GA | TRICARE PROVIDER & DME SUPPLIE |
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