Individual
DR. JIMMY L. BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
429 MITCHELL AVE, BOWDON, GA 30108-1405
(770) 258-5516
(770) 258-5517
Mailing address
429 MITCHELL AVE, BOWDON, GA 30108-1405
(770) 258-5516
(770) 258-5517
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8166
GA
Other
Enumeration date
03/11/2008
Last updated
03/11/2008
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