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Organization
CONYERS DENTAL ASSOCIATES, LLC
Active
Organization
CONYERS DENTAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN A WALLS DDS (OWNER)
(404) 444-8485
Entity
Organization
Contact information
Practice address
1455 OLD MCDONOUGH HWY SE, SUITE B, CONYERS, GA 30094-5979
(770) 483-6655
Mailing address
1455 OLD MCDONOUGH HWY SE, SUITE B, CONYERS, GA 30094-5979
(770) 483-6655
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 010715
GA
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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