| Countryside Dental - Lagrange | |
|
307 Church St Fl 1 Lagrange GA 30240-2700 | |
| (706) 884-3263 | |
| (706) 884-3263 |
| Full Name | Countryside Dental - Lagrange |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 307 Church St Fl 1, Lagrange, Georgia |
| Authorized Official Name and Position | Yokeca Nicole Watts (DENTIST, PARTNER) |
| Authorized Official Contact | 2055639877 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Countryside Dental - Lagrange 307 Church St Fl 1 Lagrange GA 30240-2700 Ph: (706) 884-3263 | Countryside Dental - Lagrange 307 Church St Fl 1 Lagrange GA 30240-2700 Ph: (706) 884-3263 |
| NPI Number | 1558223461 |
|---|---|
| Provider Enumeration Date | 11/29/2025 |
| Last Update Date | 11/29/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558223461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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