Individual
AMELIA B GRANBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
13570 N MAIN ST, TRENTON, GA 30752-2012
(706) 657-7575
(706) 657-4430
Mailing address
13570 N MAIN ST, TRENTON, GA 30752-2012
(706) 657-7575
(706) 657-4430
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013770
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN013770
GA LICENSE
GA
Enumeration date
08/14/2008
Last updated
08/14/2008
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