Provider First Line Business Practice Location Address:
1631 GORDON HIGHWAY #22 A
Provider Second Line Business Practice Location Address:
SMALL SMILES OF AUGUSTA, P.C.
Provider Business Practice Location Address City Name:
AUGUSTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-790-9309
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/20/2007