Individual
DR. MICHAEL O. VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1218 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-1808
(706) 860-0518
(706) 860-4902
Mailing address
1218 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-1808
(706) 860-0518
(706) 860-4902
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8815
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00137948B
—
GA
01
—
550572
UNITED CONCORDIA
GA
Enumeration date
07/25/2006
Last updated
07/09/2007
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