Organization
BCA GEORGIA, LLC
Active
Other names
Lakeside Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY HARPER DENT MD (CEO)
(912) 764-2455
Entity
Organization
Contact information
Practice address
1850 N COLUMBIA ST STE 3, MILLEDGEVILLE, GA 31061-7113
(478) 453-4101
Mailing address
PO BOX 1067, STATESBORO, GA 30459-1067
(912) 764-2455
(912) 764-7522
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
09/12/2022
Last updated
02/10/2023
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