Organization
GORDON HIGHWAY DENTAL GROUP, LLC
Active
Other names
Augusta Smiles Youth Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA SUSAN ZOELLER (AUTHORIZED OFFICIAL)
(615) 988-2627
Entity
Organization
Contact information
Practice address
1631 GORDON HWY, AUGUSTA, GA 30906
(706) 790-9302
(706) 790-9303
Mailing address
401 CHURCH ST STE 2210, NASHVILLE, TN 37219-2204
(615) 988-2627
(631) 857-7860
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015152
GA
Other
Enumeration date
10/12/2016
Last updated
07/05/2018
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