Provider Demographics
NPI:1104120245
Name:GEORGETOWN FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:GEORGETOWN FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:LINTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:912-660-1197
Mailing Address - Street 1:PO BOX 13989
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-0989
Mailing Address - Country:US
Mailing Address - Phone:912-660-1197
Mailing Address - Fax:912-355-2130
Practice Address - Street 1:821 KING GEORGE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-8328
Practice Address - Country:US
Practice Address - Phone:912-660-1197
Practice Address - Fax:912-355-2130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty