Individual
DR. GARY TYRONE BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
313 MOOTY BRIDGE RD STE 202, LAGRANGE, GA 30240-1809
(706) 837-0123
Mailing address
140 N DAVIS RD APT 922, LAGRANGE, GA 30241-1616
(706) 839-8499
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015909
GA
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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