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195 Greencastle Rd Tyrone GA 30290-2938 | |
| (770) 486-5585 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 195 Greencastle Rd, Tyrone, Georgia |
| Authorized Official Name and Position | Angela Holly Cope (FRONT OFFICE) |
| Authorized Official Contact | 7704865585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
195 Greencastle Rd Tyrone GA 30290-2938 Ph: () - | 195 Greencastle Rd Tyrone GA 30290-2938 Ph: (770) 486-5585 |
| NPI Number | 1699299545 |
|---|---|
| Provider Enumeration Date | 08/02/2017 |
| Last Update Date | 08/09/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699299545 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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