Bobby R Childree DMD PC
Organization Active NPI Dentist · Jasper, GA
NPI 1235247644 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1235247644
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 8754 (GA)
- Legal business name
- BOBBY R CHILDREE DMD PC
- Practice address
- 175 South Main Street
Jasper, GA 30143 - Phone
- (706) 692-2646
- Fax
- (706) 253-3202
- NPI assigned
- Aug 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Bobby Ray Childree, DMD
- Title
- President of Corporation (PC)
- Phone
- (706) 692-2646
Practitioners 2
-
Leigh Muse Griffeth, DMD
-
Spencer R Griffeth, DMD
National Provider Directory
Locations
175 S Main St
Jasper, GA 30143
Phone (706) 692-2646
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 8754 | GA | Yes |
Addresses
Primary practice location
175 South Main Street
Jasper, GA 30143
Mailing address
175 South Main Street
PO Box 698
Jasper, GA 30143
Phone (706) 692-2646
Other providers in Jasper, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.