Organization
DALTON PLASTIC SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD SHERRILL MD (OWNER)
(706) 226-3311
Entity
Organization
Contact information
Practice address
1501 BROADRICK DRIVE, SUITE 1, DALTON, GA 30720
(706) 226-3311
(706) 275-8723
Mailing address
1501 BROADRICK DRIVE, SUITE 1, DALTON, GA 30720
(706) 226-3311
(706) 275-8723
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
023677
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00245627A
—
GA
Enumeration date
10/13/2009
Last updated
03/01/2010
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