Provider Demographics
NPI:1275313538
Name:TWIILIGHT DENTAL CARE,LLC
Entity Type:Organization
Organization Name:TWIILIGHT DENTAL CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TWITTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-888-5432
Mailing Address - Street 1:6501 VETERANS PKWY BLDG 4A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-7207
Mailing Address - Country:US
Mailing Address - Phone:980-888-5432
Mailing Address - Fax:
Practice Address - Street 1:6501 VETERANS PKWY BLDG 4A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-7207
Practice Address - Country:US
Practice Address - Phone:762-261-1097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TWIILIGHT DENTAL CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-04
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental