Organization
GEORGIA DENTAL ALLIANCE OF AUGUSTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER TOMLINSON (CREDENTIALING SPECIALIST)
(678) 986-7116
Entity
Organization
Contact information
Practice address
3643 WALTON WAY EXT, AUGUSTA, GA 30909-4507
(404) 410-1340
Mailing address
3643 WALTON WAY EXT, AUGUSTA, GA 30909-4507
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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