Individual
ANDREA DAVIS WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1536 EISENHOWER PKWY, MACON, GA 31206-3130
(478) 781-4333
(478) 781-4331
Mailing address
1316 BOAT ROCK RD SW, ATLANTA, GA 30331-7316
(404) 310-6548
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN011029
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000471875
—
GA
01
—
100759
AVESIS
GA
01
—
1429244
UNITED CONCORDIA
GA
01
—
9180606
DENTAQUEST
GA
Enumeration date
08/31/2006
Last updated
11/26/2020
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