Organization
ATHENS GPR LLC
Active
Other names
Athens GPR
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH BRADLEY HALL DMD (OWNER)
(706) 726-3397
Entity
Organization
Contact information
Practice address
1360 CADUCEUS WAY STE 101, WATKINSVILLE, GA 30677-7300
(706) 543-3629
(706) 543-5107
Mailing address
PO BOX 7501, ATHENS, GA 30604-7501
(706) 715-0267
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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