Individual
LEROY BERTRAM ALFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10 LEGACY WAY, SUITE C, ADAIRSVILLE, GA 30103-2461
(770) 773-7227
(706) 291-0684
Mailing address
PO BOX 106, ROME, GA 30162-0106
(770) 773-7227
(706) 291-0684
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
008829
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00186876B
—
GA
Enumeration date
04/07/2009
Last updated
03/03/2010
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