Azalea City Family Dentistry
Organization Active NPI General Practice Dentistry · Valdosta, GA
NPI 1295978047 · NPPES record last updated Apr 9, 2009
Key facts
- NPI
- 1295978047
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN007995 (GA)
- Legal business name
- AZALEA CITY FAMILY DENTISTRY
- Practice address
- 414 Pendleton PL
Valdosta, GA 31602-2603 - Phone
- (229) 244-3700
- Fax
- (229) 247-0373
- NPI assigned
- Apr 9, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. William W Broadfoot Jr., D.D.S.
- Title
- Ceo
- Phone
- (229) 244-3700
Practitioners 1
-
James Charles Broadfoot, D.M.D.
National Provider Directory
Locations
414 Pendleton Pl
Valdosta, GA 31602
Phone (229) 244-3700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | DN007995 | GA | Yes |
Addresses
Primary practice location
414 Pendleton PL
Valdosta, GA 31602-2603
Mailing address
414 Pendleton PL
Valdosta, GA 31602-2603
Phone (229) 244-3700
Other providers in Valdosta, GA
- Curtis Lamar Avera
- Shalese Aycock
- Musa Ayyad
- Azalea Center for Plastic Surgery PC
- Azalea City Chiropractic
- Azalea Neuro and Spine Clinic PC
- Azalea Rehab Services, LLC
- Azalea Sleep Labs, Inc.
- Azalea Womens Center, PC
- McKenna Kristine Bachmann
All providers in Valdosta, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2009. 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.