Individual
DR. MICHAEL BILLINGSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2420 GREEN MOUNTAIN DR, BRASELTON, GA 30517-7015
(719) 439-4968
Mailing address
2420 GREEN MOUNTAIN DR, BRASELTON, GA 30517-7015
(719) 439-4968
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
104763
CO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN013698
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02047637
—
CO
Enumeration date
11/27/2006
Last updated
10/28/2010
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