Organization
COWETA DENTISTRY SDA PC
Active
Other names
Coweta Dentistry Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNI SNOW (CREDENTIALING COORDINATOR)
(404) 410-1340
Entity
Organization
Contact information
Practice address
15 RUTH DR, NEWNAN, GA 30265-2317
(770) 253-3171
(770) 253-9892
Mailing address
15 RUTH DR, NEWNAN, GA 30265-2317
(770) 253-3171
(770) 253-9892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
12/16/2016
Last updated
12/16/2016
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