Individual
GRIFFIN E MIZELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
100 W PARSONAGE ST, MC RAE, GA 31055-1735
(229) 868-6615
(229) 868-6615
Mailing address
PO BOX 128, MC RAE, GA 31055-0128
(229) 868-6615
(229) 868-6615
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9762
GA
Other
Enumeration date
07/14/2006
Last updated
07/08/2007
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