Provider Demographics
NPI:1851794762
Name:WORTHY FAMILY DENTISTRY, P.C.
Entity Type:Organization
Organization Name:WORTHY FAMILY DENTISTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:706-896-1204
Mailing Address - Street 1:19 S MAIN ST
Mailing Address - Street 2:P.O. BOX 601
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-3433
Mailing Address - Country:US
Mailing Address - Phone:706-896-1204
Mailing Address - Fax:706-896-1206
Practice Address - Street 1:19 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HIAWASSEE
Practice Address - State:GA
Practice Address - Zip Code:30546-3433
Practice Address - Country:US
Practice Address - Phone:706-896-1204
Practice Address - Fax:706-896-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0144221223G0001X
GADN0092141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty