Towne Lake Dental Group, LLC

NPI #1053696781 in Pooler, Georgia

Provider Information

NPI Number: 1053696781
Entity Type: Organization
Organization Name: Towne Lake Dental Group, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 13, 2011
Last Updated: Oct 13, 2011

Practice Location

Address: 125 SOUTHERN JUNCTION BLVD
Address 2: SUITE 701
City: Pooler
State: Georgia
ZIP Code: 31322-2214
Phone: (912) 330-4545

Authorized Official

Name: DR. BRIAN BEAUDREAU, D.M.D.
Title: OWNER/DENTIST
Phone: (912) 330-4545

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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