# BOBBY R CHILDREE DMD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235247644
- **Authorized official:** DR. BOBBY RAY CHILDREE DMD (PRESIDENT OF CORPORATION (PC))
- **Authorized official phone:** (706) 692-2646

## Contact information

- **Practice address:** 175 SOUTH MAIN STREET, JASPER, GA 30143
- **Practice address phone:** (706) 692-2646
- **Practice address fax:** (706) 253-3202
- **Mailing address:** 175 SOUTH MAIN STREET, PO BOX 698, JASPER, GA 30143
- **Mailing address phone:** (706) 692-2646
- **Mailing address fax:** (706) 253-3202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 8754 | GA | Yes |

## Other

- **Enumeration date:** 08/26/2006
- **Last updated:** 08/22/2020