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Organization

BLAIRSVILLE DENTISTRY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PETER BOULDEN (OWNER)
(706) 781-3340
Entity
Organization

Contact information

Practice address
10 DEER CROSSING TRCE, BLAIRSVILLE, GA 30512-1496
(706) 781-3340
Mailing address
10 DEER CROSSING TRCE, BLAIRSVILLE, GA 30512-1496
(706) 781-3340

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012542
GA

Other

Enumeration date
03/10/2016
Last updated
03/10/2016
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