Organization
GEORGIA DENTAL PROFESSIONALS, PC
Active
Parent organization
GEORGIA DENTAL PROFESSIONALS, PC
Other names
Indian Creek Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Authorized official
CEMYIRA MCDOUGAL (CREDENTIALING)
(217) 764-8609
Entity
Organization
Contact information
Practice address
4550 HIGHWAY 42 S, LOCUST GROVE, GA 30248-4111
(470) 994-7810
Mailing address
4550 HIGHWAY 42 S, LOCUST GROVE, GA 30248-4111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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