Organization
DENTISTRY FOR CHILDREN OF GAINESVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES COULTER DDS (OWNER)
(404) 389-1950
Entity
Organization
Contact information
Practice address
1350 SPRING ST NW, SIXTH FLOOR, ATLANTA, GA 30309-2864
(404) 389-1950
Mailing address
885 DAWSONVILLE HWY, GAINESVILLE, GA 30501-2643
(404) 389-1950
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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