Azalea City Family Dentistry

NPI #1295978047 in Valdosta, Georgia

Provider Information

NPI Number: 1295978047
Entity Type: Organization
Organization Name: Azalea City Family Dentistry
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 9, 2009
Last Updated: Apr 9, 2009

Practice Location

Address: 414 PENDLETON PL
City: Valdosta
State: Georgia
ZIP Code: 31602-2603
Phone: (229) 244-3700

Authorized Official

Name: DR. WILLIAM W BROADFOOT JR., D.D.S.
Title: CEO
Phone: (229) 244-3700

Specialties & Taxonomy Codes

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

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