Organization
MAGNOLIA ROOTS ENDODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLEEN BURT SELLS DMD (OWNER)
(912) 737-4044
Entity
Organization
Contact information
Practice address
100 BLUE MOON XING STE 103, POOLER, GA 31322-9809
(239) 404-0691
Mailing address
118 OAKDENE RD, POOLER, GA 31322-9783
(239) 404-0691
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
05/16/2024
Last updated
10/27/2024
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