| Fayetteville Dental Group | |
|
141 Banks Sta Suite 121-122 Fayetteville GA 30214-7504 | |
| (770) 716-9778 | |
| (770) 716-9075 |
| Full Name | Fayetteville Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 141 Banks Sta, Fayetteville, Georgia |
| Authorized Official Name and Position | Jennifer Constable (OFFICE MANAGER) |
| Authorized Official Contact | 7707169778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayetteville Dental Group 141 Banks Sta Suite 121-122 Fayetteville GA 30214-7504 Ph: (770) 716-9778 | Fayetteville Dental Group 141 Banks Sta Suite 121-122 Fayetteville GA 30214-7504 Ph: (770) 716-9778 |
| NPI Number | 1528105491 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528105491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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