Organization
PEDIATRICS OF DALTON, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA DOCKERY (ADMINISTRATOR)
(706) 278-5373
Entity
Organization
Contact information
Practice address
1409 CHATTANOOGA AVE, DALTON, GA 30720-2631
(706) 278-5373
(706) 278-5085
Mailing address
1409 CHATTANOOGA AVE, DALTON, GA 30720-2631
(706) 278-5373
(706) 278-5085
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
015426
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30019480A
—
GA
Enumeration date
05/16/2008
Last updated
06/17/2015
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