Conyers Dental Associates, Llc | |
1455 Old Mcdonough Hwy Se Suite B Conyers GA 30094-5979 | |
(770) 483-6655 | |
Not Available |
Full Name | Conyers Dental Associates, Llc |
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Speciality | Dentist |
Location | 1455 Old Mcdonough Hwy Se, Conyers, Georgia |
Authorized Official Name and Position | Shawn A Walls (OWNER) |
Authorized Official Contact | 4044448485 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Conyers Dental Associates, Llc 1455 Old Mcdonough Hwy Se Suite B Conyers GA 30094-5979 Ph: (770) 483-6655 | Conyers Dental Associates, Llc 1455 Old Mcdonough Hwy Se Suite B Conyers GA 30094-5979 Ph: (770) 483-6655 |
NPI Number | 1447796560 |
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Provider Enumeration Date | 01/12/2017 |
Last Update Date | 01/12/2017 |
Identifier | Type | State | Issuer |
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1447796560 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DN 010715 (Georgia) | Primary |
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