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MOSSY OAK DENTAL, LLC
NPI 1992290415
Clinic/Center - Dental in Leesburg, GA

Active since June 27, 2018
119 CARLTON DR, LEESBURG, GA 31763(229) 436-7231 Get Directions Write a Review

NPPES record last updated: June 27, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mossy Oak Dental, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOSSY OAK DENTAL, LLC (NPI 1992290415) is a healthcare organization registered as a dental in Leesburg, Georgia and active in the NPI registry since June 2018. The organization lists Alan Dale Ford, Dentist/owner, as its authorized official.

NPPES Registry Identity

NPI1992290415
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameMOSSY OAK DENTAL, LLC
Location Address119 CARLTON DRLeesburg, GA 31763-5652
Mailing AddressPo Box 71307Albany, GA 31708-1307 · (229) 436-7231 · Fax (229) 436-4423
Phone(229) 436-7231
Organization SubpartNo
Authorized OfficialAlan Dale FordDentist/owner · (229) 436-7231
Enumeration DateJune 27, 2018
✔ NPI 1992290415 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in GA · DN012008
119 CARLTON DR, Leesburg, GA 31763
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN S GADALLA DMD
Dentist
119 CARLTON DR
LEESBURG, GA 31763
Lee County (229) 435-1726
SARAH SMITH
Dentist
119 CARLTON DR
LEESBURG, GA 31763
Lee County (229) 435-1726

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mossy Oak Dental, LLC's NPI number?

The NPI number for Mossy Oak Dental, LLC is 1992290415. It was assigned to this organization in the NPPES registry on June 27, 2018.

Where is Mossy Oak Dental, LLC located?

Mossy Oak Dental, LLC is located at 119 Carlton Dr, Leesburg, GA 31763. The listed phone number is (229) 436-7231.

What is Mossy Oak Dental, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Mossy Oak Dental, LLC was last updated on June 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.