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819 Thompson Bridge Rd Gainesville GA 30501-1774 | |
(770) 535-8900 | |
(770) 535-8108 |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 819 Thompson Bridge Rd, Gainesville, Georgia |
Authorized Official Name and Position | Sally Evans (OWNER) |
Authorized Official Contact | 4073404304 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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819 Thompson Bridge Rd Gainesville GA 30501-1774 Ph: (770) 535-8900 | 819 Thompson Bridge Rd Gainesville GA 30501-1774 Ph: (770) 535-8900 |
NPI Number | 1215337951 |
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Provider Enumeration Date | 08/31/2014 |
Last Update Date | 08/31/2014 |
Identifier | Type | State | Issuer |
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1215337951 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | DNO13552 (Georgia) | Primary |
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