Organization
JAMES PROCTOR DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES MICHAEL PROCTOR DDS (PRESIDENT)
(770) 483-6800
Entity
Organization
Contact information
Practice address
2045 HONEY CREEK PKWY SE, CONYERS, GA 30013-2975
(770) 483-6800
Mailing address
2045 HONEY CREEK PKWY SE, CONYERS, GA 30013-2975
(770) 483-6800
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1164
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00569357B
—
GA
Enumeration date
03/27/2007
Last updated
08/22/2020
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