Individual
DR. GORDON T AUSTIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
819 DIXIE ST, CARROLLTON, GA 30117-4415
(770) 832-7374
(770) 832-7260
Mailing address
819 DIXIE ST, CARROLLTON, GA 30117-4415
(770) 832-7374
(770) 832-7260
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8598
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00380784A
—
GA
Enumeration date
07/14/2005
Last updated
07/09/2007
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