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DR. MICHAEL CRAIG WIDENER D.M.D.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1922020312

Individual Registrant:
DR. MICHAEL CRAIG WIDENER D.M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
328 EAST COLLEGE ST.  BOWDON, GA 30108 US
Tel: 770-258-2707  Fax: 770-258-8402

Contact information for business:
PO BOX 652  BOWDON, GA 30108-0652 US
Tel: 770-258-2707  Fax: 770-258-8402

Registration Information:
NPI: 1922020312
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
GA012039

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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