Organization
GEORGIA DENTAL PROFESSIONALS, PC
Active
Parent organization
GEORGIA DENTAL PROFESSIONALS, PC
Other names
AcWorth Station Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization
Contact information
Practice address
3329 COBB PKWY NW, SUITE 300, ACWORTH, GA 30101-8325
(770) 406-6601
Mailing address
3329 COBB PKWY NW, SUITE 300, ACWORTH, GA 30101-8325
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/08/2014
Last updated
09/17/2014
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