Organization
GENESIS DENTAL GROUP OPELIKA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FORREST E WATERS III DMD (OWNER/TREASURER)
(334) 281-2451
Entity
Organization
Contact information
Practice address
1995 PEPPERELL PKWY, SUITE1, OPELIKA, AL 36801-5460
(334) 281-2451
(334) 281-1087
Mailing address
3150 ZELDA CT, MONTGOMERY, AL 36106-2607
(334) 281-2451
(334) 281-1087
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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