Organization
DENTAL ONE ASSOCIATES (FAYETTEVILLE) LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (INSURANCE DIRECTOR)
(727) 726-1611
Entity
Organization
Contact information
Practice address
410 N JEFF DAVIS DR, FAYETTEVILLE, GA 30214-1630
(770) 460-9702
Mailing address
410 N JEFF DAVIS DR, FAYETTEVILLE, GA 30214-1630
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/13/2007
Last updated
08/22/2020
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