Individual
STEPHEN JOHN MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6501 PEAKE RD, BLDG 600, MACON, GA 31210-8042
(478) 477-7101
(478) 477-1728
Mailing address
6501 PEAKE RD, BLDG 600, MACON, GA 31210-8042
(478) 477-7101
(478) 477-1728
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DNO12775
GA
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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