NPI age
12 years
Enumerated 2013-10-31
Across 526 active dentist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | GA10006 | LICENSE |
| 01 (GA) | 1114017530 | GROUP NPI |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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