NPI age
18 years
Enumerated 2007-08-01
Across 4309 active dentist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (IA) | 0080200 | |
| 01 (IA) | 1932193224 | MEDICAID GROUP NPI # |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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