| Purple Dental Llc | |
|
1609 Norman Dr Ste B Valdosta GA 31601-3753 | |
| (229) 269-4607 | |
| (229) 244-6701 |
| Full Name | Purple Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 1609 Norman Dr, Valdosta, Georgia |
| Authorized Official Name and Position | Jennifer La Duc (PROVIDER RELATIONS) |
| Authorized Official Contact | 3154546000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purple Dental Llc Po Box 3189 Syracuse NY 13220-3189 Ph: (315) 454-6000 | Purple Dental Llc 1609 Norman Dr Ste B Valdosta GA 31601-3753 Ph: (229) 269-4607 |
| NPI Number | 1831637644 |
|---|---|
| Provider Enumeration Date | 02/01/2017 |
| Last Update Date | 02/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831637644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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