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Organization

SOUTHERN PEARL DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LATONYA GILLESPIE DDS (OWNER)
(404) 729-5159
Entity
Organization

Contact information

Practice address
1883 MCDONOUGH RD, HAMPTON, GA 30228-3516
(404) 729-5159
Mailing address
210 SHORELINE DR, FAYETTEVILLE, GA 30215-4665

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
05/30/2019
Last updated
05/30/2019
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