Organization
CVINGTON-CONYERS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMIE BLOUNT (DOCTOR)
(678) 625-7505
Entity
Organization
Contact information
Practice address
3162 ELM ST NE, COVINGTON, GA 30014-2461
(678) 625-7505
Mailing address
3162 ELM ST NE, COVINGTON, GA 30014-2461
(678) 625-7505
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11497
GA
Other
Enumeration date
01/09/2008
Last updated
01/09/2008
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