Cornelia Dental, LLC

NPI #1023435310 in Cornelia, Georgia

Provider Information

NPI Number: 1023435310
Entity Type: Organization
Organization Name: Cornelia Dental, LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Mar 25, 2014
Last Updated: Mar 25, 2014

Practice Location

Address: 105 HIGHLAND AVE
City: Cornelia
State: Georgia
ZIP Code: 30531-4366
Phone: (706) 778-8645

Authorized Official

Name: DR. RALPH LEON JACKSON, DDS
Title: OWNER
Phone: (706) 778-8645

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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