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Organization
PALMETTO FAMILY DENTAL OF FAYETTE COUNTY, PC
Active
Organization
PALMETTO FAMILY DENTAL OF FAYETTE COUNTY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN BRUNSON DDS (PRESIDENT/OWNER)
(706) 580-9670
Entity
Organization
Contact information
Practice address
210 TRILITH PKWY STE 130, FAYETTEVILLE, GA 30214-4615
(706) 580-9670
Mailing address
210 TRILITH PKWY STE 130, FAYETTEVILLE, GA 30214-4615
(706) 580-9670
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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