Coweta Dentistry Sda PC
Dentist, General Practice in Newnan, GA. Organization (NPI-2).
NPI number1164064481
StatusActive
Last updated in NPPESOct 9, 2019
Details
- NPI
- 1164064481
- Entity type
- Organization (NPI-2)
- Legal business name
- Coweta Dentistry Sda PC
- Organization subpart
- No
- Enumeration date
- Oct 9, 2019
- Last updated
- Oct 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Coweta Dentistry Associates (Doing Business As)
Practice location
203 Millard Farmer Ind BlvdNewnan, GA 30263-1012
Phone 770-253-3595
Mailing address
203 Millard Farmer Ind BlvdNewnan, GA 30263-1012
Phone 770-253-3595
Authorized official
Christopher Sims
Credentialing Manager
4705521823
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