| Athens Gpr Llc | |
|
1360 Caduceus Way Ste 101 Watkinsville GA 30677-7300 | |
| (706) 543-3629 | |
| (706) 543-5107 |
| Full Name | Athens Gpr Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1360 Caduceus Way Ste 101, Watkinsville, Georgia |
| Authorized Official Name and Position | Kenneth Bradley Hall (OWNER) |
| Authorized Official Contact | 7067263397 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Athens Gpr Llc Po Box 7501 Athens GA 30604-7501 Ph: (706) 715-0267 | Athens Gpr Llc 1360 Caduceus Way Ste 101 Watkinsville GA 30677-7300 Ph: (706) 543-3629 |
| NPI Number | 1407699739 |
|---|---|
| Provider Enumeration Date | 06/14/2024 |
| Last Update Date | 06/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407699739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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