Aesthetic Dental Assoc Of Ne Ga Llc | |
1520a Jennings Mill Rd Bogart GA 30622-2543 | |
(706) 353-1958 | |
(706) 353-3939 |
Full Name | Aesthetic Dental Assoc Of Ne Ga Llc |
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Speciality | Dentist |
Location | 1520a Jennings Mill Rd, Bogart, Georgia |
Authorized Official Name and Position | R. Lawrence George (OWNER) |
Authorized Official Contact | 7063531958 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Aesthetic Dental Assoc Of Ne Ga Llc 1520a Jennings Mill Rd Bogart GA 30622-2543 Ph: (706) 353-1958 | Aesthetic Dental Assoc Of Ne Ga Llc 1520a Jennings Mill Rd Bogart GA 30622-2543 Ph: (706) 353-1958 |
NPI Number | 1457793895 |
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Provider Enumeration Date | 07/26/2013 |
Last Update Date | 07/26/2013 |
Identifier | Type | State | Issuer |
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1457793895 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DN007721 (Georgia) | Primary |
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