Organization
KID'S ZONE DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA L WEBB (OFFICE MANAGER)
(706) 882-0591
Entity
Organization
Contact information
Practice address
307 CHURCH ST, SUITE A, LAGRANGE, GA 30240-2700
(706) 882-0591
(706) 845-9546
Mailing address
307 CHURCH ST, SUITE A, LAGRANGE, GA 30240-2700
(706) 882-0591
(706) 845-9546
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN008745
GA
122300000X
Dentist
DN014796
GA
122300000X
Dentist
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000136848D
—
GA
05
—
003148248A
—
GA
05
—
191678896B
—
GA
Enumeration date
03/22/2016
Last updated
03/22/2016
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