Individual
DR. J ALLEN BRASELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-1001
(706) 721-2371
(706) 721-6778
Mailing address
1430 JOHN WESLEY GILBERT DRIVE GC-1012, AUGUSTA, GA 30912-0001
(706) 721-2371
(706) 721-6778
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN0008257
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00044734B
—
GA
05
—
ZG8257
—
SC
Enumeration date
05/18/2006
Last updated
03/10/2021
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