Organization · Type 2 NPI
South Port Dentistry
Dental Clinic/Center · Brunswick, GA
NPI number
1013778042
Active
Practice location
200 Hyde Park Cmns
Brunswick, GA 31523-6601
Mailing address
288 Redfern Vlg
St. Simons Island, GA 31522-2536
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
Another provider at this address
Other dental clinic/center providers in Brunswick
About NPI 1013778042
South Port Dentistry's National Provider Identifier is 1013778042, issued on Jan 17, 2024. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Brunswick, GA. The record was last updated on Jan 17, 2024.