NPI age
19 years
Enumerated 2006-06-14
Across 4309 active dentist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 559750905A | |
| 01 (GA) | 81635 | UNITED CONC. |
| 01 (GA) | 0007529 | DORAL |
| 01 (GA) | 100678 | AVESIS |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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