Mp Dental, LLC

NPI #1366940884 in Jefferson, Georgia

Provider Information

NPI Number: 1366940884
Entity Type: Organization
Organization Name: Mp Dental, LLC
Primary Specialty: Dentist
Enumeration Date: Jan 30, 2018
Last Updated: Jan 30, 2018

Practice Location

Address: 1679 OLD PENDERGRASS RD
City: Jefferson
State: Georgia
ZIP Code: 30549-2705
Phone: (770) 297-0401

Authorized Official

Name: TIFFANY CROWE
Title: DIRECTOR OF OPERATIONS
Phone: (770) 297-0401

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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