Organization
PROFESSIONAL DENTAL ALLIANCE OF WARNER ROBINS MOODY RD, LLC
Active
Other names
Central Georgia Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HOWARD MA (CREDENTIALING SPECIALIST)
(724) 698-2029
Entity
Organization
Contact information
Practice address
2521 MOODY RD, WARNER ROBINS, GA 31088-6117
(478) 929-8603
(478) 929-0242
Mailing address
11 S MILL ST STE 200, NEW CASTLE, PA 16101-3680
(724) 698-2500
(844) 399-0385
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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