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Organization
KODAK FAMILY DENTAL, PLLC
Active
Organization
KODAK FAMILY DENTAL, PLLC
Active
Other names
Kodak Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOELAN JURGEN SCHAFER DMD (OWNER)
(509) 960-1744
Entity
Organization
Contact information
Practice address
2946 WINFIELD DUNN PKWY STE 301, KODAK, TN 37764-4319
(865) 465-7058
Mailing address
3428 WOODWARD DOWN TRL, BUFORD, GA 30519-5054
(509) 960-1744
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/07/2020
Last updated
09/07/2020
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