Individual
DR. FOREST REED PAGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
139 E JEFFERSON ST, MADISON, GA 30650-1362
(706) 342-3636
Mailing address
139 E JEFFERSON ST, MADISON, GA 30650-1362
(706) 342-3636
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11105
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00528701A
—
GA
Enumeration date
07/18/2006
Last updated
07/08/2007
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