Organization
DENTAL SLEEP THERAPY OF MACON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS S JOHNSON DMD (MANAGING MEMBER)
(478) 722-9865
Entity
Organization
Contact information
Practice address
4885 RIVERSIDE DR STE 101, MACON, GA 31210-1164
(478) 305-7282
(866) 494-6123
Mailing address
105 BROADLEAF DR, MACON, GA 31210-1921
(478) 722-1111
(866) 494-6123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
10/12/2024
Last updated
11/19/2024
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