| Omalee Dental Llc | |
|
14 Sixth Ave Omaha GA 31821 | |
| (229) 838-4203 | |
| (229) 838-4204 |
| Full Name | Omalee Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 14 Sixth Ave, Omaha, Georgia |
| Authorized Official Name and Position | Robert E Lee (OWNER) |
| Authorized Official Contact | 2298384203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omalee Dental Llc 14 Sixth Ave Box 200 Omaha GA 31821 Ph: (229) 838-4203 | Omalee Dental Llc 14 Sixth Ave Omaha GA 31821 Ph: (229) 838-4203 |
| NPI Number | 1831326826 |
|---|---|
| Provider Enumeration Date | 06/17/2009 |
| Last Update Date | 06/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831326826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN010226 (Georgia) | Primary |