Pine Mountain Family Dentistry, Llc

LBN: Pine Mountain Family Dentistry, Llc
Pine Mountain Family Dentistry, Llc is an health care organization with primary practice located at 8944 Hamilton Road , Pine Mountain GA 31822. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Pine Mountain Family Dentistry, Llc can be contacted via phone (706) 663-2272, or through Harden, Sidney Dauster via phone (706) 663-2272.

Contact Information

Primary practice address
8944 Hamilton Road Pine Mountain GA 31822
Fax: (706) 663-2075
Website:
Authorized official contact:
Name: Harden, Sidney Dauster Doctor of Dental Medicine (DMD)

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DNO12733 Georgia
Dental Providers / Dentist 122300000X DNO08005 Georgia

Profile Details

NPI number 1780915165
LBN Legal business name Pine Mountain Family Dentistry, Llc
DBA Doing business as
Authorized official Harden, Sidney Dauster Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 25th, 2010
Last updated Jan 25th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780915165 NPPES
Georgia MEDICAID 000045295A
Georgia MEDICAID 594312970B

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