Organization
BRIAN A BAIN DDS III PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN ALEXANDER BAIN DDS (OWNER)
(770) 258-5516
Entity
Organization
Contact information
Practice address
514 W BANKHEAD HWY, SUITE 600, VILLA RICA, GA 30180-1736
(770) 456-2550
Mailing address
429 MITCHELL AVE, BOWDON, GA 30108-1405
(770) 258-5516
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014278
GA
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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