Organization
LIBERTY TRAILS ENDODONTICS, LLC
Active
Other names
Coastal Endodontics
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER LEA DDS (OWNER)
(912) 756-5960
Entity
Organization
Contact information
Practice address
111 E MILLS AVE, HINESVILLE, GA 31313-2616
(912) 463-4405
(912) 463-4939
Mailing address
111 E MILLS AVE, HINESVILLE, GA 31313-2616
(912) 463-4405
(912) 463-4939
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN013079
GA
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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