Plantation Dental Associates

NPI 1063505113 - Dentist - 1223G0001X

NPI Details
NPI 1063505113
Enumeration Date 10/02/2006
Last Updated 06/17/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JACK HEYWARD JACK
Position OWNER/DENTIST
Phone (912) 638-9001
Fax (912) 634-9819
Practice Location
300 MAIN ST
STE 101
ST SIMONS ISLAND GA, 31522-1666, US
Phone (912) 638-9001
Fax (912) 634-9819
Business Location
300 MAIN ST
STE 101
ST SIMONS ISLAND GA, 31522-1666, US
Phone (912) 638-9001
Fax (912) 634-9819
Toxanomy
Taxonomy Code 1223G0001X
License State Georgia
License Number DN008285
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According to our database, Plantation Dental Associates NPI is 1063505113, taxonomy code is 1223G0001X and license number is DN008285, license state is located at Georgia. Plantation Dental Associates physically located at 300 Main St, St Simons Island GA, 31522-1666. NPI Number 1033115704 has the healthcare provider type.

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1063505113 NPI number is provided on an as is basis without warranty of any kind. 1063505113 is maintained by the National Plan & Provider Enumeration System. The contents of Plantation Dental Associates are for informational purposes only.