NPI | 1922113554 |
---|---|
Doing Business As | WEST GEORGIA FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | LAURA V BAGLEY Manager 770-949-1680 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 12185) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 7704) |
1223G0001X Dentist, General Practice (Licence: GA 6770) | |
Enumeration Date | 2006-08-21 |
Last Update Date | 2008-07-14 |