Individual
BRIAN A WOMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
420 MCDONOUGH PKWY, MCDONOUGH, GA 30253-8946
(770) 914-2808
(678) 432-9193
Mailing address
235 EAGLES LANDING WAY, MCDONOUGH, GA 30253-4221
(770) 914-2808
(678) 432-9193
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9213
GA
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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