Individual
DR. IRA BRINSON GUY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1289 CEDAR SHOALS DR, ATHENS, GA 30605-3509
(706) 353-7018
Mailing address
1289 CEDAR SHOALS DR, ATHENS, GA 30605-3509
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
GA 8766
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00138003B
—
GA
01
—
V08766
BCBS
—
Enumeration date
08/07/2006
Last updated
07/08/2007
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