Port City Family Dental Associates

NPI #1417112533 in Bainbridge, Georgia

Provider Information

NPI Number: 1417112533
Entity Type: Organization
Organization Name: Port City Family Dental Associates
Primary Specialty: Dentist
Enumeration Date: Jul 29, 2008
Last Updated: Jul 29, 2008

Practice Location

Address: 709 E SHOTWELL ST
City: Bainbridge
State: Georgia
ZIP Code: 39819-4063
Phone: (229) 246-5081

Authorized Official

Name: MRS. SUZI RUSH-KRAFT
Title: OFFICE MANAGER
Phone: (229) 246-5081

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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