Provider Demographics
NPI:1376288308
Name:SOUTHEASTERN DENTAL CENTER-COLUMBUS LLC
Entity Type:Organization
Organization Name:SOUTHEASTERN DENTAL CENTER-COLUMBUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:ARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-628-0011
Mailing Address - Street 1:222 CHAMBLESS LN
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:GA
Mailing Address - Zip Code:31811-6144
Mailing Address - Country:US
Mailing Address - Phone:706-628-0011
Mailing Address - Fax:
Practice Address - Street 1:3650 GURLEY DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5623
Practice Address - Country:US
Practice Address - Phone:706-571-0201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental