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Organization

DANA W MULLIS DMD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANA W MULLIS (CEO DMD)
(478) 374-1127
Entity
Organization

Contact information

Practice address
1003 PLAZA AVE, EASTMAN, GA 31023
(478) 374-1127
(478) 374-3588
Mailing address
PO BOX 4098, EASTMAN, GA 31023-4098
(478) 374-1127
(478) 374-3588

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
011878
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00803151B
GA
Enumeration date
03/02/2007
Last updated
08/22/2020
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