Organization
FAMILY PRACTICE DENTAL CARE OF STATESBORO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE CYRIL MADSON DMD (OWNER)
(912) 764-9187
Entity
Organization
Contact information
Practice address
1046 NORTHSIDE DR E, STATESBORO, GA 30458-1002
(912) 764-9187
(912) 764-7530
Mailing address
1046 NORTHSIDE DR E, STATESBORO, GA 30458-1002
(912) 764-9187
(912) 764-7530
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8617
GA
Other
Enumeration date
05/31/2007
Last updated
10/23/2014
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