| Nova Dental, Pc | |
|
1134 Senoia Rd Ste A2 Tyrone GA 30290-1622 | |
| (770) 253-5885 | |
| Not Available |
| Full Name | Nova Dental, Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1134 Senoia Rd Ste A2, Tyrone, Georgia |
| Authorized Official Name and Position | Juliane S Reynolds (GENERAL DENTIST) |
| Authorized Official Contact | 7702535885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Dental, Pc 31 Jessica Ln Newnan GA 30263-7069 Ph: (770) 253-5885 | Nova Dental, Pc 1134 Senoia Rd Ste A2 Tyrone GA 30290-1622 Ph: (770) 253-5885 |
| NPI Number | 1346582566 |
|---|---|
| Provider Enumeration Date | 03/26/2013 |
| Last Update Date | 03/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346582566 | NPI | - | NPPES |
| S01262012767946 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN013488 (Georgia) | Primary |
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