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Contact Information

ADVANCED DENTAL CARE
3211 WILDWOOD PLANTATION DR
VALDOSTA, GA31605-1042
 Phone: 229-242-4441
 Fax: 229-242-4471
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ADVANCED DENTAL CARE

NPI Number 1104152404
LBN Legal business name ADVANCED DENTAL CARE
Authorized official WILLIAM MOORMAN - (OWNER/DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 10/22/2009
Last updated 10/22/2009 - About 17 years ago
Identifiers
GA License # DN011637
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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