Organization
EAGLIN FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON S EAGLIN DDS (DENTIST/OWNER)
(770) 471-2333
Entity
Organization
Contact information
Practice address
248 ARROWHEAD BLVD, JONESBORO, GA 30236-1106
(770) 471-2333
Mailing address
248 ARROWHEAD BLVD, JONESBORO, GA 30236-1106
(770) 471-2333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
BE9572581
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102167
AVESIS
GA
01
—
182357
DORAL
GA
05
—
777472578B
—
GA
Enumeration date
03/21/2008
Last updated
03/21/2008
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