Individual
DR. SALLY YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2 LESTER CT, STATESBORO, GA 30458-2118
(912) 489-1386
(912) 764-8533
Mailing address
715 NORTHSIDE DR E, SUITE 5, PMB #395, STATESBORO, GA 30458-4712
(912) 489-1386
(912) 764-8533
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
10099
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00328314B
—
GA
Enumeration date
03/21/2008
Last updated
03/21/2008
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