| Cornelia Dental, Llc | |
|
105 Highland Ave Cornelia GA 30531-4366 | |
| (706) 778-8645 | |
| (706) 776-2650 |
| Full Name | Cornelia Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 105 Highland Ave, Cornelia, Georgia |
| Authorized Official Name and Position | Ralph Leon Jackson (OWNER) |
| Authorized Official Contact | 7067788645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornelia Dental, Llc 105 Highland Ave Cornelia GA 30531-4366 Ph: (706) 778-8645 | Cornelia Dental, Llc 105 Highland Ave Cornelia GA 30531-4366 Ph: (706) 778-8645 |
| NPI Number | 1023435310 |
|---|---|
| Provider Enumeration Date | 03/25/2014 |
| Last Update Date | 03/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023435310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN009940 (Georgia) | Primary |
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