Organization
LAKE OCONEE ENDODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CHADWICK WILLIAMS D.M.D. (PRESIDENT)
(706) 825-0829
Entity
Organization
Contact information
Practice address
1011 PARKSIDE CMNS STE 103, GREENSBORO, GA 30642-4553
(706) 484-9844
(706) 484-9846
Mailing address
1011 PARKSIDE CMNS STE 103, GREENSBORO, GA 30642-4553
(706) 484-9844
(706) 484-9846
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN012544
GA
Other
Enumeration date
06/26/2012
Last updated
10/26/2022
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