Organization
MH DENTAL P.C.
Active
Other names
Vital Smiles Georgia
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL G. WALKER (COLLECTIONS MANAGER)
(205) 271-6851
Entity
Organization
Contact information
Practice address
1030A WEST GORDON AVE, ALBANY, GA 31701
(229) 432-9555
(229) 432-0907
Mailing address
1030A WEST GORDON AVE, ALBANY, GA 31701
(229) 432-9555
(229) 432-0907
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112036
—
GA
01
—
1892015
UNITED CONCORDIA
GA
01
—
200075582
BCBS
GA
05
—
39888
—
GA
05
—
714338776A
—
GA
Enumeration date
01/25/2007
Last updated
07/24/2012
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