Organization
PERIODONTICS & DENTAL IMPLANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN HARVEY (OWNER)
(770) 254-0401
Entity
Organization
Contact information
Practice address
163 JEFFERSON PKWY, NEWNAN, GA 30263-5823
(770) 254-0401
(770) 254-8483
Mailing address
163 JEFFERSON PKWY, NEWNAN, GA 30263-5823
(770) 254-0401
(770) 254-8483
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
011840
GA
Other
Enumeration date
01/08/2007
Last updated
12/08/2014
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