| Towne Lake Dental Group, Llc | |
|
125 Southern Junction Blvd Suite 701 Pooler GA 31322-2214 | |
| (912) 330-4545 | |
| Not Available |
| Full Name | Towne Lake Dental Group, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 125 Southern Junction Blvd, Pooler, Georgia |
| Authorized Official Name and Position | Brian Beaudreau (OWNER/DENTIST) |
| Authorized Official Contact | 9123304545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Towne Lake Dental Group, Llc 125 Southern Junction Blvd Suite 701 Pooler GA 31322-2214 Ph: (912) 330-4545 | Towne Lake Dental Group, Llc 125 Southern Junction Blvd Suite 701 Pooler GA 31322-2214 Ph: (912) 330-4545 |
| NPI Number | 1053696781 |
|---|---|
| Provider Enumeration Date | 10/13/2011 |
| Last Update Date | 10/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053696781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 09617 (Georgia) | Primary |
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