NPI age
20 years
Enumerated 2006-05-16
Across 358 active dentist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1418385 | TRICARE |
| 05 (SC) | ZG0319 |
Part of a multi-provider practice. 114 other active providers share this practice address in NPPES.
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