Organization
AESTHETIC RESTORATIVE DENTISTRY, P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. W TAYLOR DOMINY JR. D.M.D (OWNER)
(770) 631-0044
Entity
Organization
Contact information
Practice address
5000 SHAKERAG HL, PEACHTREE CITY, GA 30269-3367
(770) 631-0044
(770) 631-9434
Mailing address
5000 SHAKERAG HL, PEACHTREE CITY, GA 30269-3367
(770) 631-0044
(770) 631-9434
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DN010888
GA
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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