| Aesthetic Dental Assoc Of Ne Ga Llc | |
|
1520a Jennings Mill Rd Bogart GA 30622-2543 | |
| (706) 353-1958 | |
| (706) 353-3939 |
| Full Name | Aesthetic Dental Assoc Of Ne Ga Llc |
|---|---|
| Speciality | Dentist |
| Location | 1520a Jennings Mill Rd, Bogart, Georgia |
| Authorized Official Name and Position | R. Lawrence George (OWNER) |
| Authorized Official Contact | 7063531958 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aesthetic Dental Assoc Of Ne Ga Llc 1520a Jennings Mill Rd Bogart GA 30622-2543 Ph: (706) 353-1958 | Aesthetic Dental Assoc Of Ne Ga Llc 1520a Jennings Mill Rd Bogart GA 30622-2543 Ph: (706) 353-1958 |
| NPI Number | 1457793895 |
|---|---|
| Provider Enumeration Date | 07/26/2013 |
| Last Update Date | 07/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457793895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN007721 (Georgia) | Primary |
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