Organization
DAMIAN SOMMERVILLE, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAMIAN L SOMMERVILLE DDS (OWNER)
(770) 423-0324
Entity
Organization
Contact information
Practice address
1951 CANTON RD, STE 310, MARIETTA, GA 30066-6327
(770) 423-0324
Mailing address
1951 CANTON RD, STE 310, MARIETTA, GA 30066-6327
(770) 423-0324
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014899
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003160400A
—
GA
Enumeration date
07/28/2015
Last updated
03/29/2016
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