Organization
DOGWOOD PEDIATRIC DENTISTRY OF POOLER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN STEVENS (OFFICE MANAGER)
(912) 661-1391
Entity
Organization
Contact information
Practice address
100 BLUE MOON XING STE 105, POOLER, GA 31322-9809
(912) 661-1391
Mailing address
203 COMMONWEALTH AVE, PORT WENTWORTH, GA 31407-1916
(912) 661-1391
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/06/2022
Last updated
06/16/2022
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