Organization
GEORGIA DENTAL PROFESSIONALS, PC
Active
Parent organization
GEORGIA DENTAL PROFESSIONALS, PC
Other names
Pooler Parkway Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization
Contact information
Practice address
155 TRADER WAY, POOLER, GA 31322
(912) 208-5594
Mailing address
155 TRADERS WAY, SUITE 400, POOLER, GA 31322-4300
(912) 348-3155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012289
GA
Other
Enumeration date
01/30/2015
Last updated
05/25/2016
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