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Organization

AESTHETIC RESTORATIVE DENTISTRY, P. C.

Active
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Organization

AESTHETIC RESTORATIVE DENTISTRY, P. C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. W TAYLOR DOMINY JR. D.M.D (OWNER)
(770) 631-0044
Entity
Organization

Contact information

Practice address
5000 SHAKERAG HL, PEACHTREE CITY, GA 30269-3367
(770) 631-0044
(770) 631-9434
Mailing address
5000 SHAKERAG HL, PEACHTREE CITY, GA 30269-3367
(770) 631-0044
(770) 631-9434

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DN010888
GA

Other

Enumeration date
12/22/2016
Last updated
12/22/2016
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