Organization
AUGUSTA DENTAL ASSOCIATES, LLC
Active
Other names
Michael O. Vernon, DMD, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER MICHAEL MOLDOVAN DMD (OWNER/DENTIST)
(706) 860-0518
Entity
Organization
Contact information
Practice address
1218 AUGUSTA WEST PARKWAY, AUGUSTA, GA 30909-1808
(706) 860-0518
(706) 860-4902
Mailing address
1218 AUGUSTA WEST PARKWAY, AUGUSTA, GA 30909-1808
(706) 860-0518
(706) 860-4902
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012377
GA
1223G0001X
General Practice Dentistry
8815
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00137948B
—
GA
05
—
00922655A
—
GA
Enumeration date
07/11/2006
Last updated
07/14/2023
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