Provider Demographics
NPI:1265450126
Name:WILLOW POINT DENTAL ART CENTER
Entity Type:Organization
Organization Name:WILLOW POINT DENTAL ART CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:NARDE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:706-327-3364
Mailing Address - Street 1:6233 VETERANS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-3539
Mailing Address - Country:US
Mailing Address - Phone:706-327-3364
Mailing Address - Fax:706-327-1103
Practice Address - Street 1:6233 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3539
Practice Address - Country:US
Practice Address - Phone:706-327-3364
Practice Address - Fax:706-327-1103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0112561223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty