Ford Avenue Family Dentistry, LLC

NPI #1619444981 in Richmond Hill, Georgia

Provider Information

NPI Number: 1619444981
Entity Type: Organization
Organization Name: Ford Avenue Family Dentistry, LLC
Primary Specialty: Dentist
Enumeration Date: Oct 25, 2018
Last Updated: Oct 25, 2018

Practice Location

Address: 10230 FORD AVE
City: Richmond Hill
State: Georgia
ZIP Code: 31324-8854
Phone: (912) 756-2936

Authorized Official

Name: DR. RAY LINTON WALLACE III, DMD
Title: DENTIST
Phone: (912) 695-2801

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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