Organization
MD ENDODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW DIANDRETH DMD (PRESIDENT)
(912) 268-2800
Entity
Organization
Contact information
Practice address
1804 FREDERICA RD STE B, SAINT SIMONS ISLAND, GA 31522-2044
(912) 268-2800
Mailing address
1804 FREDERICA RD STE B, SAINT SIMONS ISLAND, GA 31522-2044
(912) 268-2800
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
04/22/2024
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