Provider Demographics
NPI:1417168493
Name:DENTAL ASSOCIATES OF DUBLIN, INC.
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES OF DUBLIN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:H
Authorized Official - Last Name:SELPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-272-3727
Mailing Address - Street 1:1617 RICE AVE
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-3522
Mailing Address - Country:US
Mailing Address - Phone:478-272-3727
Mailing Address - Fax:478-272-8317
Practice Address - Street 1:1617 RICE AVE
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3522
Practice Address - Country:US
Practice Address - Phone:478-272-3727
Practice Address - Fax:478-272-8317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10879122300000X
GADN012942122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty