Organization
DENTRUST, P.C.
Active
Parent organization
DENTRUST PC
Other names
Dentrust Dental Ft. Stewart
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTRUST PC
Authorized official
AMANDA ANNE CLARK (DIRECTOR OF CREDENTIALING)
(267) 927-5000
Entity
Organization
Contact information
Practice address
112 VILSECK RD, FT.STEWART, GA 31315
(267) 927-5000
Mailing address
1221 VINEWOOD DR, SEFFNER, FL 33584-4829
(813) 451-4503
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN014535
DR.CAPLIN'S LIC GA
GA
Enumeration date
08/26/2021
Last updated
08/26/2021
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