Individual
HOWARD BOOTH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
250 CHARTER LN, MACON, GA 31210-4544
(478) 471-8103
(478) 471-9186
Mailing address
250 CHARTER LANE G-2, MACON, GA 31210
(478) 471-8103
(478) 471-9186
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8838
GA
Other
Enumeration date
06/29/2006
Last updated
07/08/2007
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