# INGLESIDE DENTAL ASSOICATES, P.C.

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

## Provider details

- **NPI number:** 1780712224
- **Authorized official:** DR. JENNIFER JACKSON ROBERSON D.M.D. (OWNER)
- **Authorized official phone:** (478) 743-3441

## Contact information

- **Practice address:** 2440 INGLESIDE AVE, MACON, GA 31204-2088
- **Practice address phone:** (478) 743-3441
- **Practice address fax:** (478) 743-1542
- **Mailing address:** 2440 INGLESIDE AVE, MACON, GA 31204-2088
- **Mailing address phone:** (478) 743-3441
- **Mailing address fax:** (478) 743-1542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0200082 | GA | Yes |

## Other

- **Enumeration date:** 02/28/2007
- **Last updated:** 08/22/2020