Organization
DANSFORTH, INC
Active
Other names
Medcare General, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAWN R WILSON M.D. (SOLE PROPRIETOR)
(770) 856-8736
Entity
Organization
Contact information
Practice address
245 PEACHTREE INDUSTRIAL BLVD, SUITE100, SUGAR HILL, GA 30518-9126
(770) 856-8736
Mailing address
PO BOX 56, SUWANEE, GA 30024-0056
(770) 856-8736
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
047279
GA
Other
Enumeration date
07/05/2012
Last updated
07/05/2012
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