Organization
SOUTHLAND CHILDRENS DENTISTRY VALDOSTA, LLC
Active
Other names
South Georgia Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY DAVIS (OFFICE MANAGER)
(229) 247-3200
Entity
Organization
Contact information
Practice address
3227 N OAK STREET EXT STE A, VALDOSTA, GA 31605-7415
(229) 247-3200
(229) 241-1900
Mailing address
3227 N OAK STREET EXT STE A, VALDOSTA, GA 31605-7415
(229) 247-3200
(229) 241-1900
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN014813
GA
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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