Kid'S Zone Dentistry, LLC
Dentist in Lagrange, GA. Organization (NPI-2).
NPI number1073975868
StatusActive
Last updated in NPPESMar 22, 2016
Details
- NPI
- 1073975868
- Entity type
- Organization (NPI-2)
- Legal business name
- Kid'S Zone Dentistry, LLC
- Organization subpart
- No
- Enumeration date
- Mar 22, 2016
- Last updated
- Mar 22, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | GA | Yes |
| 122300000X | Dentist | DN008745 | GA | |
| 122300000X | Dentist | DN014796 | GA |
Practice location
307 Church StSuite A
Lagrange, GA 30240-2700
Phone 706-882-0591 · Fax 706-845-9546
Mailing address
307 Church StSuite A
Lagrange, GA 30240-2700
Phone 706-882-0591 · Fax 706-845-9546
Authorized official
Laura L Webb
Office Manager
7068820591
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