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Organization

MOON ROAD COSMETIC & FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAYO OBEBE DMD (DIRECTOR)
(706) 243-3000
Entity
Organization

Contact information

Practice address
7209 MOON RD, COLUMBUS, GA 31909-1798
(706) 243-3000
Mailing address
7209 MOON RD, COLUMBUS, GA 31909-1798
(706) 243-3000

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
011235
GA
261QD0000X
Dental Clinic/Center
Primary
011235
GA

Other

Enumeration date
09/13/2007
Last updated
09/13/2007
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