Organization
GEORGIA DENTAL PROFESSIONALS, PC
Active
Parent organization
GEORGIA DENTAL PROFESSIONALS, PC
Other names
Barrel & Vine Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
1046 BRASELTON VILLAGE PKWY, BRASELTON, GA 30517-2643
(706) 471-1975
(706) 471-0328
Mailing address
1046 BRASELTON VILLAGE PKWY, BRASELTON, GA 30517-2643
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/27/2025
Last updated
06/27/2025
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