Provider First Line Business Practice Location Address:
DENTAL COLLEGE OF GEORGIA 1430 JOHN WESLEY GILBERT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUGUSTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30912-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-656-4203
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/11/2020