Organization
GEORGIA DENTAL PROFESSIONALS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA PETERSEN (CREDENTIALING TEAM LEAD)
(217) 540-8972
Entity
Organization
Contact information
Practice address
755 COMMERCE DR, SUITE 513, DECATUR, GA 30030-2627
(404) 377-7711
(404) 377-6040
Mailing address
755 COMMERCE DR, SUITE 513, DECATUR, GA 30030-2627
(404) 377-7711
(404) 377-6040
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7624
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922164672
DR. THOMAS J. PRICE
GA
Enumeration date
12/28/2006
Last updated
08/29/2018
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