# SOUTHERN PEARL DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942868450
- **Authorized official:** DR. LATONYA GILLESPIE DDS (OWNER)
- **Authorized official phone:** (404) 729-5159

## Contact information

- **Practice address:** 1883 MCDONOUGH RD, HAMPTON, GA 30228-3516
- **Practice address phone:** (404) 729-5159
- **Mailing address:** 210 SHORELINE DR, FAYETTEVILLE, GA 30215-4665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 05/30/2019
- **Last updated:** 05/30/2019