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501 Park St Palmetto GA 30268-1007 | |
| (770) 463-4541 | |
| (770) 463-9184 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 501 Park St, Palmetto, Georgia |
| Authorized Official Name and Position | Jordan Albert Brunson (PRESIDENT) |
| Authorized Official Contact | 7704634541 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
501 Park St Palmetto GA 30268-1007 Ph: (770) 463-4541 | 501 Park St Palmetto GA 30268-1007 Ph: (770) 463-4541 |
| NPI Number | 1841580560 |
|---|---|
| Provider Enumeration Date | 04/14/2011 |
| Last Update Date | 08/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841580560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN013693 (Georgia) | Primary |
Gary L. Watts Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Park St, Palmetto, GA 30268 Phone: 770-463-4541 Fax: 770-463-9184 |