Colquitt Dental Care,llc

NPI #1992065106 in Colquitt, Georgia

Provider Information

NPI Number: 1992065106
Entity Type: Organization
Organization Name: Colquitt Dental Care,llc
Primary Specialty: Clinic/Center - Dental
Enumeration Date: May 22, 2012
Last Updated: May 22, 2012

Practice Location

Address: 115 N CUTHBERT ST
City: Colquitt
State: Georgia
ZIP Code: 39837-3401
Phone: (229) 758-3345

Authorized Official

Name: DR. ROBERT A LANE, DMD
Title: OWNER/DENTIST
Phone: (229) 758-3345

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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