Organization
STATESBORO PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANJALI PURI PATEL DMD (DENTIST/OWNER)
(478) 456-5907
Entity
Organization
Contact information
Practice address
613 E GRADY ST, STATESBORO, GA 30458-5104
(478) 456-5907
Mailing address
101 IRONGATE PL, STATESBORO, GA 30458-9195
(478) 456-5907
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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