Organization
NOVUS ORTHODONTICS OF GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNI TOMLINSON (CREDENTIALING SPECIALIST)
(678) 986-7116
Entity
Organization
Contact information
Practice address
300 NORTHLAKE DR, PEACHTREE CITY, GA 30269-3524
(770) 487-8298
(770) 487-5372
Mailing address
300 NORTHLAKE DR, PEACHTREE CITY, GA 30269-3524
(770) 487-8298
(770) 487-5372
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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