Organization
CLELAND PERIODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON CLELAND FRASER JR. DMD (PERIODONTICS)
(678) 423-5000
Entity
Organization
Contact information
Practice address
1605 HIGHWAY 34 E STE A, NEWNAN, GA 30265-2156
(678) 423-5000
(678) 423-5005
Mailing address
1605 HIGHWAY 34 E STE A, NEWNAN, GA 30265-2156
(678) 423-5000
(678) 423-5005
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN012684
GA
Other
Enumeration date
04/19/2007
Last updated
08/22/2020
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