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General Practice Dentistry

NPI: 1275219586Individual

Specialties, Licenses & Credentials

Dentist — General Practice

Code: 1223G0001X

DN123426(GA)

Student in an Organized Health Care Education/Training Program

Code: 390200000X

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Contact & Hours

Address
2239 HIGHWAY 20 SE STE H
CONYERS, GA 30013

Quick Facts

NPI
1275219586
Entity Type
Individual
Gender
Male
Medicare
Not confirmed
Specialties
2
Locations
2

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