Organization
GRIFFIN DENTAL SPECIALTIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON CLELAND FRASER JR. DMD (PERIODONTIST)
(770) 412-6575
Entity
Organization
Contact information
Practice address
218 S 11TH ST, GRIFFIN, GA 30224-2810
(770) 412-6575
(770) 412-9089
Mailing address
218 S 11TH ST, GRIFFIN, GA 30224-2810
(770) 412-6575
(770) 412-9089
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN012684
GA
Other
Enumeration date
04/17/2007
Last updated
07/23/2008
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