| Element Dental Group Llc | |
|
3456 Wrightsboro Rd Augusta GA 30909-2678 | |
| (706) 251-7917 | |
| Not Available |
| Full Name | Element Dental Group Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3456 Wrightsboro Rd, Augusta, Georgia |
| Authorized Official Name and Position | Michelle Jacomino-barnes (DIRECTOR CREDENTIALING & ENROLLMENT) |
| Authorized Official Contact | 8132709497 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Element Dental Group Llc Po Box 70887 Cleveland OH 44190-0887 Ph: () - | Element Dental Group Llc 3456 Wrightsboro Rd Augusta GA 30909-2678 Ph: (706) 251-7917 |
| NPI Number | 1033893797 |
|---|---|
| Provider Enumeration Date | 06/13/2023 |
| Last Update Date | 09/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033893797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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