Organization
EPPS VILLAGE FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES HERSCHEL POWELL III D.M.D. (OWNER/DENTIST)
(706) 227-0773
Entity
Organization
Contact information
Practice address
1720 EPPS BRIDGE PKWY, SUITE 110, ATHENS, GA 30606-6132
(706) 227-0773
(706) 227-1642
Mailing address
1720 EPPS BRIDGE PKWY, SUITE 110, ATHENS, GA 30606-6132
(706) 227-0773
(706) 227-1642
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN008795
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN008795
STATE DENTAL LICENSE #
GA
Enumeration date
08/22/2006
Last updated
08/22/2020
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