| Fairview Dental Llc | |
|
210 Fairview Rd Ellenwood GA 30294-2704 | |
| (281) 728-5042 | |
| Not Available |
| Full Name | Fairview Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 210 Fairview Rd, Ellenwood, Georgia |
| Authorized Official Name and Position | Ami Patel (DENTIST) |
| Authorized Official Contact | 2817285042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairview Dental Llc 210 Fairview Rd Ellenwood GA 30294-2704 Ph: (281) 728-5042 | Fairview Dental Llc 210 Fairview Rd Ellenwood GA 30294-2704 Ph: (281) 728-5042 |
| NPI Number | 1891280673 |
|---|---|
| Provider Enumeration Date | 06/25/2018 |
| Last Update Date | 06/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891280673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN015055 (Georgia) | Primary |
Cassandra R Stewart Dds Mph Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5937 Highway 42, Ellenwood, GA 30294 Phone: 248-342-7057 Fax: 678-567-7928 | |
T.e.bruno, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5937 Highway 42, Ellenwood, GA 30294 Phone: 770-961-6272 Fax: 770-961-0472 |