Provider Demographics
NPI:1275687642
Name:EFFINGHAM DENTAL ASSOCIATES,P.C.
Entity Type:Organization
Organization Name:EFFINGHAM DENTAL ASSOCIATES,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-754-6822
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:105 SOUTH LAUREL ST.
Mailing Address - City:SPRINGFIELD
Mailing Address - State:GA
Mailing Address - Zip Code:31329-0517
Mailing Address - Country:US
Mailing Address - Phone:912-754-6822
Mailing Address - Fax:912-754-4368
Practice Address - Street 1:105 S LAUREL ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:GA
Practice Address - Zip Code:31329-9255
Practice Address - Country:US
Practice Address - Phone:912-754-6822
Practice Address - Fax:912-754-4368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental