| Grimsley Dental Clinic, Llc | |
| 
					115 N Cuthbert St Colquitt GA 39837-3401  | |
| (229) 758-3345 | |
| (229) 758-3339 | 
| Full Name | Grimsley Dental Clinic, Llc | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 115 N Cuthbert St, Colquitt, Georgia | 
| Authorized Official Name and Position | Joseph W Grimsley (DENTIST) | 
| Authorized Official Contact | 2297583345 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Grimsley Dental Clinic, Llc 115 N Cuthbert St Colquitt GA 39837-3401 Ph: (229) 758-3345  | Grimsley Dental Clinic, Llc 115 N Cuthbert St Colquitt GA 39837-3401 Ph: (229) 758-3345  | 
| NPI Number | 1265681092 | 
|---|---|
| Provider Enumeration Date | 09/17/2008 | 
| Last Update Date | 09/17/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1265681092 | NPI | - | NPPES | 
| 300014425A | Medicaid | GA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN010031 (Georgia) | Secondary | 
| 261QD0000X | Clinic/center - Dental | DN013335 (Georgia) | Primary | 
Chapman Family Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 N Cuthbert St, Colquitt, GA 39837 Phone: 229-600-0012  | |
Colquitt Dental Care,llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 N Cuthbert St, Colquitt, GA 39837 Phone: 229-758-3345 Fax: 229-758-3339  |