Organization
GORDON W. WOMACK DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMONIA LEONARD (CREDENTIALING SPECIAILST)
(678) 244-4844
Entity
Organization
Contact information
Practice address
3300 KEMP RD, BEAVERCREEK, OH 45431
(937) 426-2653
Mailing address
3300 KEMP RD, BEAVERCREEK, OH 45431-4200
(937) 426-2653
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
07/25/2018
Last updated
07/26/2018
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