Individual
DR. MICHAEL CRAIG WIDENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
328 EAST COLLEGE ST., BOWDON, GA 30108
(770) 258-2707
(770) 258-8402
Mailing address
PO BOX 652, BOWDON, GA 30108-0652
(770) 258-2707
(770) 258-8402
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012039
GA
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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