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
Phone: (706) 663-2272
Fax: (706) 663-2075
Website:
Authorized official contact:
Name: Harden, Sidney Dauster Doctor of Dental Medicine (DMD)
Phone: (706) 663-2272
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780915165 | NPPES |
| Georgia | MEDICAID | 000045295A | |
| Georgia | MEDICAID | 594312970B |
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