Organization
SOH OF GEORGIA OZF PC
Active
Parent organization
SOH OF GEORGIA OZF PC
Other names
Conyers Endodonic Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOH OF GEORGIA OZF PC
Authorized official
ASHLY SUNSHINE (CREDENTIALING SPECIALIST)
(314) 413-2803
Entity
Organization
Contact information
Practice address
1920 HIGHWAY 20 SE STE A, CONYERS, GA 30013-2048
(706) 800-9118
Mailing address
1422 ELBRIDGE PAYNE RD STE 240, CHESTERFIELD, MO 63017-8544
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
08/08/2023
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