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Organization
BCA GEORGIA, LLC
Active
Organization
BCA GEORGIA, LLC
Active
Other names
Lakeside Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY HARPER DENT MD (CEO)
(912) 764-2455
Entity
Organization
Contact information
Practice address
1850 N COLUMBIA ST STE 3, MILLEDGEVILLE, GA 31061-7113
(478) 453-4101
Mailing address
PO BOX 1067, STATESBORO, GA 30459-1067
(912) 764-2455
(912) 764-7522
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
09/12/2022
Last updated
02/10/2023
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