Organization
KIDS ZONE DENTISTRY & LAGRANGE FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUCK PITTS D.M.D (OWNER)
(706) 882-0591
Entity
Organization
Contact information
Practice address
307 CHURCH ST STE A, LAGRANGE, GA 30240-2700
(706) 882-0591
(706) 845-9546
Mailing address
307 CHURCH ST STE A, LAGRANGE, GA 30240-2700
(706) 882-0591
(706) 845-9546
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN009828
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191678896B
—
GA
Enumeration date
08/14/2013
Last updated
08/14/2013
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