Organization
GEORGIA DENTAL PROFESSIONALS, PC
Active
Parent organization
GEORGIA DENTAL PROFESSIONALS, PC
Other names
Seaside Lifetime Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Authorized official
CASSANDRA N TEUTSCH (CREDENTIALING COORDINATOR)
(217) 540-8972
Entity
Organization
Contact information
Practice address
165 JUNIPER CIR, BRUNSWICK, GA 31520-1953
(912) 554-4552
Mailing address
165 JUNIPER CIR, BRUNSWICK, GA 31520-1953
(912) 554-4552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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