Plantation Dental Associates

NPI #1063505113 in St Simons Island, Georgia

Provider Information

NPI Number: 1063505113
Entity Type: Organization
Organization Name: Plantation Dental Associates
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 2, 2006
Last Updated: Jun 17, 2008

Practice Location

Address: 300 MAIN ST
Address 2: STE 101
City: St Simons Island
State: Georgia
ZIP Code: 31522-1666
Phone: (912) 638-9001

Authorized Official

Name: DR. JACK HEYWARD MELTON, DMD
Title: OWNER/DENTIST
Phone: (912) 638-9001

Specialties & Taxonomy Codes

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

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