Organization
WEST GEORGIA DENTISTRY FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARON BINGHAM-SHULTZ D.M.D. (DENTIST)
(678) 384-1787
Entity
Organization
Contact information
Practice address
3827 JIMMY LEE SMITH PKWY, SUITE 121, HIRAM, GA 30141-2804
(678) 384-1787
(678) 384-1459
Mailing address
3827 JIMMY LEE SMITH PKWY, SUITE 121, HIRAM, GA 30141-2804
(678) 384-1787
(678) 384-1459
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
06110450
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156788755
—
GA
Enumeration date
03/19/2012
Last updated
03/19/2012
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