| Mossy Oak Dental, Llc | |
|
119 Carlton Dr Leesburg GA 31763-5652 | |
| (229) 436-7231 | |
| Not Available |
| Full Name | Mossy Oak Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 119 Carlton Dr, Leesburg, Georgia |
| Authorized Official Name and Position | Alan Dale Ford (DENTIST/OWNER) |
| Authorized Official Contact | 2294367231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mossy Oak Dental, Llc Po Box 71307 Albany GA 31708-1307 Ph: (229) 436-7231 | Mossy Oak Dental, Llc 119 Carlton Dr Leesburg GA 31763-5652 Ph: (229) 436-7231 |
| NPI Number | 1992290415 |
|---|---|
| Provider Enumeration Date | 06/27/2018 |
| Last Update Date | 06/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992290415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN012008 (Georgia) | Primary |
Dr. Chad A. Bush, D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 919 Us Highway 19 S, Leesburg, GA 31763 Phone: 229-888-3550 Fax: 229-888-0055 | |
Williams Bush Margeson And Wright Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 919 Us Hwy 19 South, Leesburg, GA 31763 Phone: 229-888-3550 Fax: 229-888-0055 |