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Organization

GEORGIA DENTAL PROFESSIONALS, PC

Active
Parent organization
GEORGIA DENTAL PROFESSIONALS, PC
Other names
Austell Family Dental Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization

Contact information

Practice address
780 EAST WEST CONNECTOR SW, SUITE 108, AUSTELL, GA 30106
(678) 271-3706
Mailing address
780 EAST WEST CONNECTOR SW, SUITE 108, AUSTELL, GA 30106

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
10/09/2015
Last updated
10/09/2015
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