Organization
MOUNTAIN CITY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN DRIESSE DDS (OWNER DOCTOR)
(707) 445-4377
Entity
Organization
Contact information
Practice address
49 GORDON RD, SUITE 102, JASPER, GA 30143
(770) 744-5437
Mailing address
7925 SCENIC RIDGE WAY, BALL GROUND, GA 30107-5102
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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