Organization
MEDICAL DENTAL MANAGEMENT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY BUFORD D.D.S. (DENTIST)
(770) 604-9944
Entity
Organization
Contact information
Practice address
1150 HAMMOND DR NE, C-3120, ATLANTA, GA 30328-5334
(770) 604-9944
(770) 604-9945
Mailing address
1150 HAMMOND DR NE, C-3120, ATLANTA, GA 30328-5334
(770) 604-9944
(770) 604-9945
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9184187
DORAL DENTAL
GA
Enumeration date
03/20/2008
Last updated
03/20/2008
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