Individual
DR. FRANK DE LATOUR III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
300 EAST HOSPTIAL DRIVE, FORT GORDON, GA 30905
(706) 787-5322
Mailing address
300 EAST HOSPITAL DRIVE, FORT GORDON, GA 30905
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401414463
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10106
SC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DNF000451
GA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DNF000451
GA
Other
Enumeration date
08/07/2014
Last updated
01/11/2024
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