NPI age
19 years
Enumerated 2007-01-04
Across 4309 active dentist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000163127A | |
| 05 (GA) | 9182324 | |
| 05 (GA) | 101112 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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