| J. Rena Owsley-brown | |
|
1275 Highway 54 W Suite 204 Fayetteville GA 30214-4549 | |
| (770) 461-5500 | |
| (770) 461-1033 |
| Full Name | J. Rena Owsley-brown |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1275 Highway 54 W, Fayetteville, Georgia |
| Authorized Official Name and Position | J. Rena Owsley-brown (DENTIST/OWNER) |
| Authorized Official Contact | 7704615500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Rena Owsley-brown 1275 Highway 54 W Suite 204 Fayetteville GA 30214-4549 Ph: (770) 461-5500 | J. Rena Owsley-brown 1275 Highway 54 W Suite 204 Fayetteville GA 30214-4549 Ph: (770) 461-5500 |
| NPI Number | 1801068754 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 04/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801068754 | NPI | - | NPPES |
| 110289 | Other | GA | DORAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DNO12893 (Georgia) | Primary |
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