Bennett & Maxwell Family Dentistry | |
2415 Andover Dr Valdosta GA 31602-1280 | |
(229) 671-1900 | |
(229) 671-1999 |
Full Name | Bennett & Maxwell Family Dentistry |
---|---|
Speciality | Dentist |
Location | 2415 Andover Dr, Valdosta, Georgia |
Authorized Official Name and Position | Douglas Courtney Maxwell (OWNER) |
Authorized Official Contact | 2296711900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Bennett & Maxwell Family Dentistry 2415 Andover Dr Valdosta GA 31602-1280 Ph: (229) 671-1900 | Bennett & Maxwell Family Dentistry 2415 Andover Dr Valdosta GA 31602-1280 Ph: (229) 671-1900 |
NPI Number | 1417108366 |
---|---|
Provider Enumeration Date | 10/08/2008 |
Last Update Date | 10/08/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1417108366 | NPI | - | NPPES |
000961276A | Medicaid | GA | |
000963256A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 11562 (Georgia) | Primary |
122300000X | Dentist | 11534 (Georgia) | Secondary |
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