Organization
EASTMAN DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY MARIE HENDERSON (OFFICE MANAGER)
(478) 374-7719
Entity
Organization
Contact information
Practice address
501 GRIFFIN AVE, EASTMAN, GA 31023-6712
(478) 374-7719
(478) 374-7044
Mailing address
P.O. BOX 247, EASTMAN, GA 31023
(478) 374-7719
(478) 374-7044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
05/19/2011
Last updated
05/19/2011
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