Organization
LOGANVILLE DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE HAMMOND (OFFICE MANAGER)
(770) 466-0580
Entity
Organization
Contact information
Practice address
150 HIGHWAY 78, LOGANVILLE, GA 30052-2277
(770) 466-0580
Mailing address
150 HIGHWAY 78, LOGANVILLE, GA 30052-2277
(770) 466-0580
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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