Organization
EASTMAN FAMILY DENTAL CENTER LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BYRD DANIEL HARRELL DMD (DENTIST)
(478) 374-4716
Entity
Organization
Contact information
Practice address
421 PLAZA AVE, EASTMAN, GA 31023-6749
(478) 374-4716
Mailing address
421 PLAZA AVE, EASTMAN, GA 31023-6749
(478) 374-4716
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN008989
GA
1223G0001X
General Practice Dentistry
DN013743
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000281575A
—
GA
05
—
661860075A
—
GA
Enumeration date
03/23/2010
Last updated
10/01/2012
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