Organization
COVINGTON FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN RAYMOND HENDRICKS JR. DDS (OWNER)
(404) 375-7326
Entity
Organization
Contact information
Practice address
4168 BAKER ST NE, COVINGTON, GA 30014-1404
(770) 787-2230
Mailing address
4168 BAKER ST NE, COVINGTON, GA 30014-1404
(770) 787-2230
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10491
GA
Other
Enumeration date
12/17/2012
Last updated
12/17/2012
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