Organization
SELECT DENTAL GA, LLC
Active
Other names
Select Dental GA
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE CARIDE (CREDENTIALING)
(727) 784-2721
Entity
Organization
Contact information
Practice address
1834 WARM SPRINGS RD, COLUMBUS, GA 31904-8029
(706) 324-1834
Mailing address
2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/05/2021
Last updated
03/07/2023
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