NPI age
15 years
Enumerated 2011-05-19
Across 2660 active dentist providers in Georgia.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 203717975A | |
| 05 (GA) | 00044789C |
Multi-provider organization. 1 individual provider on file at this primary address.
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