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Organization

HAMILTON COSMETIC AND IMPLANT DENTISTRY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BOLIVAR LUPERON DMD (OWNER)
(404) 903-8684
Entity
Organization

Contact information

Practice address
2725 HAMILTON MILL RD, SUIT 700, BUFORD, GA 30519-4187
(770) 932-8577
Mailing address
2725 HAMILTON MILL RD, SUIT 700, BUFORD, GA 30519-4187
(770) 932-8577

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
DN013214
GA

Other

Enumeration date
06/05/2012
Last updated
06/05/2012
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