Individual
DR. LARRY JASON PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4965 FRIENDSHIP RD, SUITE 105, BUFORD, GA 30518-1700
(770) 614-7122
(770) 614-7211
Mailing address
4965 FRIENDSHIP RD, SUITE 105, BUFORD, GA 30518-1700
(770) 614-7122
(770) 614-7211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012442
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00940783B
—
GA
Enumeration date
04/03/2007
Last updated
07/08/2007
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