Organization
STACEY KINSEY, DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES V. KOGLER FACMPE (PRACTICE ADMINISTRATOR)
(770) 949-3797
Entity
Organization
Contact information
Practice address
6043 PRESTLEY MILL RD, SUITE A, DOUGLASVILLE, GA 30134-2280
(770) 949-3797
(770) 949-9077
Mailing address
6043 PRESTLEY MILL RD, SUITE A, DOUGLASVILLE, GA 30134-2280
(770) 949-3797
(770) 949-9077
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/18/2006
Last updated
08/22/2020
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