Organization
KODAK FAMILY DENTAL, PLLC
Active
Other names
Kodak Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NOELAN JURGEN SCHAFER DMD (OWNER)
(509) 960-1744
Entity
Organization
Contact information
Practice address
2946 WINFIELD DUNN PKWY STE 301, KODAK, TN 37764-4319
(865) 465-7058
Mailing address
3428 WOODWARD DOWN TRL, BUFORD, GA 30519-5054
(509) 960-1744
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/07/2020
Last updated
09/07/2020
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