Organization
MACON GA ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA HOLLAND OLIVER (PRACTICE ADMINISTRATOR)
(478) 746-7686
Entity
Organization
Contact information
Practice address
3312 NORTHSIDE DR, BUILDING B # 150, MACON, GA 31210-2500
(478) 746-7686
(478) 254-3870
Mailing address
3312 NORTHSIDE DR, BUILDING B # 150, MACON, GA 31210-2500
(478) 746-7686
(478) 254-3870
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
GA
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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