Organization
COOSA DENTAL SLEEP THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID B GANDY DDS (OWNER)
(770) 748-7736
Entity
Organization
Contact information
Practice address
109 EAST AVE, CEDARTOWN, GA 30125-2921
(770) 748-7736
Mailing address
109 EAST AVE, CEDARTOWN, GA 30125-2921
(770) 748-7736
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN010447
GA
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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