Organization
GEORGIA DENTAL PROFESSIONALS, PC
Active
Parent organization
GEORGIA DENTAL PROFESSIONALS, PC
Other names
Green Street Smiles
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Authorized official
KIM WILSON (CRED SUPERVISOR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
615 GREEN ST NW, GAINESVILLE, GA 30501-3378
(770) 532-2336
(770) 536-3905
Mailing address
615 GREEN ST NW, GAINESVILLE, GA 30501-3378
(770) 532-2336
(770) 536-3905
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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