NPI age
16 years
Enumerated 2010-03-25
Across 2660 active dentist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | RPH011407 | PHARMACY LICENSE |
| 05 (GA) | 00245341A4 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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