Organization
COBB FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOGAN V GORDON (BUSINESS MANAGER)
(770) 944-8620
Entity
Organization
Contact information
Practice address
5345 FLOYD RD SW STE M, MABLETON, GA 30126-2270
(770) 944-8620
Mailing address
5345 FLOYD RD SW STE M, MABLETON, GA 30126-2270
(770) 944-8620
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012338
GA
Other
Enumeration date
10/08/2009
Last updated
10/08/2009
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