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Organization

DENTAL PROFESSIONALS OF GEORGIA, P.C.

Active
Parent organization
DENTAL PROFESSIONALS OF GEORGIA, P.C.
Other names
Calumet Family Dentistry
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENTAL PROFESSIONALS OF GEORGIA, P.C.
Authorized official
CASSANDRA TEUTSCH (CREDENTIALING COORDINATOR)
(217) 540-8972
Entity
Organization

Contact information

Practice address
116 CALUMET CENTER RD, LAGRANGE, GA 30241-6703
(706) 882-2937
Mailing address
116 CALUMET CENTER RD, LAGRANGE, GA 30241-6703
(706) 882-2937

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
12/29/2016
Last updated
12/29/2016
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