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Organization

PALMETTO FAMILY DENTAL OF FAYETTE COUNTY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JORDAN BRUNSON DDS (PRESIDENT/OWNER)
(706) 580-9670
Entity
Organization

Contact information

Practice address
210 TRILITH PKWY STE 130, FAYETTEVILLE, GA 30214-4615
(706) 580-9670
Mailing address
210 TRILITH PKWY STE 130, FAYETTEVILLE, GA 30214-4615
(706) 580-9670

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
08/16/2023
Last updated
08/16/2023
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