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Individual

TAYLER BRINSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-1704
(706) 723-4506
Mailing address
440 WESTHAVEN CT, GROVETOWN, GA 30813-0760
(912) 293-7582

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015901
GA
390200000X
Student in an Organized Health Care Education/Training Program
DN015901
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DN015901
DENTAL LICENSE
GA
Enumeration date
03/08/2019
Last updated
12/19/2024
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