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Organization
MH ORTHODONTICS
Active
Organization
MH ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL WALKER (CREDENTIALING MANAGER)
(770) 420-8462
Entity
Organization
Contact information
Practice address
1030 W GORDON AVE STE A, ALBANY, GA 31701-4515
(229) 432-9555
Mailing address
125 TOWNPARK DR NW, SUITE 300, KENNESAW, GA 30144-5803
(770) 420-8462
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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