Individual
ZACK KALIB MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
320 E HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-5102
Mailing address
854 GOODALE DR., AUGUSTA, GA 30909
(619) 962-7329
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13423741
UT
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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