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Organization

COUNTRYSIDE DENTAL - LAGRANGE

Active
Other names
Countryside Dental & Aesthetics
Organization subpart
No

Provider details

NPI number
Authorized official
YOKECA NICOLE WATTS DMD (DENTIST, PARTNER)
(205) 563-9877
Entity
Organization

Contact information

Practice address
307 CHURCH ST FL 1, LAGRANGE, GA 30240-2700
(706) 884-3263
(706) 884-3263
Mailing address
307 CHURCH ST FL 1, LAGRANGE, GA 30240-2700
(706) 884-3263
(706) 884-3263

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
11/29/2025
Last updated
11/29/2025
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