Organization
GREENLEA DENTAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDY TAYLOR DDS (DENTIST)
(770) 306-2996
Entity
Organization
Contact information
Practice address
6740 SHANNON PKWY STE 2, UNION CITY, GA 30291-2058
(770) 306-2996
(770) 306-0004
Mailing address
6740 SHANNON PKWY STE 2, UNION CITY, GA 30291-2058
(770) 306-2996
(770) 306-0004
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
GA10999
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00521298A
—
GA
Enumeration date
04/13/2007
Last updated
08/22/2020
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