Organization
COWETA DENTISTRY SDA PC
Active
Other names
COWETA DENTISTRY ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER SIMS (CREDENTIALING MANAGER)
(470) 552-1823
Entity
Organization
Contact information
Practice address
203 MILLARD FARMER IND BLVD, NEWNAN, GA 30263-1012
(770) 253-3595
Mailing address
203 MILLARD FARMER IND BLVD, NEWNAN, GA 30263-1012
(770) 253-3595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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