| Georgia Dental Professionals, Pc | |
| 
					2998 Panola Rd Stonecrest GA 30038-2394  | |
| (043) 228-0404 | |
| Not Available | 
| Full Name | Georgia Dental Professionals, Pc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 2998 Panola Rd, Stonecrest, Georgia | 
| Authorized Official Name and Position | Tabatha Lemke (CREDENTIALING COORDINATOR) | 
| Authorized Official Contact | 2175406078 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Georgia Dental Professionals, Pc 2998 Panola Rd Stonecrest GA 30038-2394 Ph: (043) 228-0404  | Georgia Dental Professionals, Pc 2998 Panola Rd Stonecrest GA 30038-2394 Ph: (043) 228-0404  | 
| NPI Number | 1992479893 | 
|---|---|
| Provider Enumeration Date | 08/04/2021 | 
| Last Update Date | 08/04/2021 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1992479893 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |