Organization
DENTAL PROFESSIONALS OF GEORGIA, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF GEORGIA, P.C.
Other names
Dental Care of Clayton
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF GEORGIA, P.C.
Authorized official
LORI EDMONDS (CREDENTIALING COORDINATOR)
(217) 540-8468
Entity
Organization
Contact information
Practice address
436 WARWOMAN RD, CLAYTON, GA 30525-5105
(706) 782-5414
Mailing address
436 WARWOMAN RD, CLAYTON, GA 30525-5105
(706) 782-5414
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/23/2013
Last updated
03/29/2016
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