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Individual

KENT CHASTAIN SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2305 LULLWATER RD, ALBANY, GA 31707
(229) 883-1306
(229) 883-1306
Mailing address
2305 LULLWATER RD, ALBANY, GA 31707
(229) 883-1306
(229) 883-1357

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10366
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00902492A
GA
Enumeration date
11/07/2006
Last updated
07/08/2007
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