Organization
AESTHETIC DENTAL ASSOC OF NE GA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R. LAWRENCE GEORGE DMD (OWNER)
(706) 353-1958
Entity
Organization
Contact information
Practice address
1520A JENNINGS MILL RD, BOGART, GA 30622-2543
(706) 353-1958
(706) 353-3939
Mailing address
1520A JENNINGS MILL RD, BOGART, GA 30622-2543
(706) 353-1958
(706) 353-3939
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN007721
GA
Other
Enumeration date
07/26/2013
Last updated
07/26/2013
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