Organization
THE DENTURE PLACE AT MCDONOUGH
Active
Other names
THE DENTURE PLACE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARL DOUGLAS HENSON DDS (OWNER)
(770) 957-1113
Entity
Organization
Contact information
Practice address
175 DECATUR RD, SUITE B, MCDONOUGH, GA 30253-2024
(770) 957-1113
(770) 957-2182
Mailing address
175 DECATUR RD, SUITE B, MCDONOUGH, GA 30253-2024
(770) 957-1113
(770) 957-2182
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN007434
GA
1223G0001X
General Practice Dentistry
DN013862
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051664G
—
GA
05
—
312341163B
—
GA
Enumeration date
10/21/2009
Last updated
10/21/2009
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