| Dental Hygiene Program | |
|
415 E 3rd Ave Rome GA 30161-3241 | |
| (706) 295-6760 | |
| Not Available |
| Full Name | Dental Hygiene Program |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 415 E 3rd Ave, Rome, Georgia |
| Authorized Official Name and Position | Thomas Mcdaniel (SUPERVISING DENTIST) |
| Authorized Official Contact | 7062956760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Hygiene Program 415 E 3rd Ave Rome GA 30161-3241 Ph: (706) 295-6760 | Dental Hygiene Program 415 E 3rd Ave Rome GA 30161-3241 Ph: (706) 295-6760 |
| NPI Number | 1598931321 |
|---|---|
| Provider Enumeration Date | 05/01/2008 |
| Last Update Date | 05/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598931321 | NPI | - | NPPES |
| DNF000218 | Other | GA | STATE DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DNF000218 (Georgia) | Primary |
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