Organization
GEORGIA MOBILE DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JUBAN DDS (MANAGING MEMBER)
(225) 927-8663
Entity
Organization
Contact information
Practice address
8564 JEFFERSON HWY, SUITE A, BATON ROUGE, LA 70809-2197
(225) 927-8663
Mailing address
8564 JEFFERSON HWY, SUITE A, BATON ROUGE, LA 70809-2197
(225) 927-8663
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/28/2016
Last updated
09/28/2016
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