Provider First Line Business Practice Location Address:
2785 BUFORD HIGHWAY
Provider Second Line Business Practice Location Address:
BUILDING B SUITE 101 DULUTH DENTAL SERVICES
Provider Business Practice Location Address City Name:
DULUTH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30096-2866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-476-3332
Provider Business Practice Location Address Fax Number:
770-622-1577
Provider Enumeration Date:
12/05/2006