Individual
DR. JOHN RODWAY MACKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, GG-1024, AUGUSTA, GA 30912-1001
(706) 721-9633
(706) 723-0266
Mailing address
1120 15TH ST, GC-1024, AUGUSTA, GA 30912-0004
(706) 721-9633
(706) 723-0266
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN8584
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000846447A
—
GA
05
—
ZG8584
—
SC
Enumeration date
05/22/2006
Last updated
01/12/2012
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