| Donerlson-mccullough Dental Center | |
|
2339 Lake Harbin Rd Morrow GA 30260 | |
| (770) 961-1222 | |
| Not Available |
| Full Name | Donerlson-mccullough Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2339 Lake Harbin Rd, Morrow, Georgia |
| Authorized Official Name and Position | Darryal Donerlson Mccullough (OWNER) |
| Authorized Official Contact | 7709611222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donerlson-mccullough Dental Center 2339 Lake Harbin Rd Morrow GA 30260 Ph: (770) 961-1222 | Donerlson-mccullough Dental Center 2339 Lake Harbin Rd Morrow GA 30260 Ph: (770) 961-1222 |
| NPI Number | 1871687624 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871687624 | NPI | - | NPPES |
| 39154 | Other | GA | AVESIS |
| 1312005 | Other | GA | UNITED CONCORDIA |
| 167133 | Other | GA | DORAL DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10775 (Georgia) | Primary |
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