Organization
NOVUS ORTHODONTICS OF GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNI TOMLINSON (CREDENTIALING SPECIALIST)
(678) 986-7116
Entity
Organization
Contact information
Practice address
15 RUTH DR, NEWNAN, GA 30265-2317
(770) 253-3171
(770) 253-9892
Mailing address
15 RUTH DR, NEWNAN, GA 30265-2317
(770) 253-3171
(770) 253-9892
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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