Organization
LOGANVILLE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PONNIE D POISAL (DMD / OWNER)
(770) 466-3114
Entity
Organization
Contact information
Practice address
3973 ATLANTA HWY, SUITE 100, LOGANVILLE, GA 30052-3752
(770) 466-3114
(770) 466-3777
Mailing address
3973 ATLANTA HWY, SUITE 100, LOGANVILLE, GA 30052-3752
(770) 466-3114
(770) 466-3777
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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