Individual
DR. JUSTIN PAUL PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
28 BUTLER ST, MIDWAY, GA 31320-4294
(912) 880-2288
Mailing address
120 LONGLEAF CIR, POOLER, GA 31322-9388
(678) 559-5353
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015706
GA
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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