Judson T. Connell, DMDM
Dentist, General Practice in Suwanee, GA. Individual provider (NPI-1).
NPI number1154483576
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1154483576
- Entity type
- Individual (NPI-1)
- Name
- Mr. Judson T. Connell
- Credential
- DMDM
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 14, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DO10993 | GA | Yes |
Practice location
3895 Johns Creek PkwySuwanee, GA 30024-1295
Phone 770-623-8877
Mailing address
3895 Johns Creek PkwySuwanee, GA 30024-1295
Phone 770-623-8877
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