Michael Clarkson

Individual provider Active NPI General Practice Dentistry · Blairsville, GA

NPI 1891879656 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1891879656
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN012994 (GA)
Practice address
3431 Murphy Hwy
Blairsville, GA 30512
Phone
(706) 865-0357
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN012994GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chattahoochee Dental Associates General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012994 GA Yes

Addresses

Primary practice location

3431 Murphy Hwy
Blairsville, GA 30512

Mailing address

PO Box 353
Maysville, GA 30558-0353
Phone (706) 865-0357

Other providers in Blairsville, GA

All providers in Blairsville, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.