Organization
J KENNETH WELDON, JR, DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. KENNETH WELDON JR. DMD (OWNER)
(706) 754-1015
Entity
Organization
Contact information
Practice address
172 PROFESSIONAL PARK DR, CLARKESVILLE, GA 30523-5536
(706) 754-1015
Mailing address
PO BOX 1239, CLARKESVILLE, GA 30523-0021
(706) 754-1015
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
011386
GA
Other
Enumeration date
02/28/2007
Last updated
08/22/2020
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