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Sgpc, Pc
Pediatric Dentist in Valdosta, Georgia
NPI 1104128263

Sgpc, Pc is a Pediatric Dentist based in Valdosta, GA and is specialized in Pediatric Dentistry. Sgpc, Pc practices in Valdosta, GA. The NPI Number for Sgpc, Pc is 1104128263 and holds a License No. DN014976 (Georgia).

The current practice location address for Sgpc, Pc is 3227 N Oak Street Ext, Valdosta, GA and can be reached out via phone at 229-247-3200.

Location: 3227 N Oak Street Ext, Valdosta, GA, 31605-7416
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104128263
Provider Name
Sgpc, Pc
Credential
Provider Entity Type
Organization
Address
3227 N Oak Street Ext, Valdosta, GA, 31605-7416
Phone Number
229-247-3200
Fax Number
Provider Enumeration Date
11/23/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
102640352A 05 GA
00917067B 05 GA
003162889B 05 GA
institution
Provider Business Practice Location Address Details
Address
3227 N Oak Street Ext
City
Valdosta
State
Georgia
Zip
31605-7416
Phone Number
229-247-3200
Fax Number
person
Provider Business Mailing Address Details
Address
3227 N Oak Street Ext
City
Valdosta
State
Georgia
Zip
31605-7416
Phone Number
229-247-3200
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DN014976 (Georgia)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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