| Fayette Dental Group Pc | |
|
720 W Lanier Ave Fayetteville GA 30214 | |
| (770) 683-2284 | |
| Not Available |
| Full Name | Fayette Dental Group Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 720 W Lanier Ave, Fayetteville, Georgia |
| Authorized Official Name and Position | Tash-marie Cheney (COO) |
| Authorized Official Contact | 7706832284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayette Dental Group Pc 720 W Lanier Ave Fayetteville GA 30214 Ph: () - | Fayette Dental Group Pc 720 W Lanier Ave Fayetteville GA 30214 Ph: (770) 683-2284 |
| NPI Number | 1356810634 |
|---|---|
| Provider Enumeration Date | 11/16/2018 |
| Last Update Date | 11/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356810634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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