DENTURES AND FAMILY DENTISTRY
Managed Care Organizations in Stone Mountain, GA

License number
Georgia DN11497
Category
Managed Care Organizations
Type
Health Maintenance Organization
Owner
Name: DR. JIMMIE LEE BLOUNT DDS
Title: OWNER/ DOCTOR
Phone: (770) 482-7800
Address
Address
1825 C SUITE 14, Stone Mountain, GA 30087
National Provider ID: 1396071270
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DENTURES AND FAMILY DENTISTRY PC

1825 Rockbridge Rd, Stone Mountain, GA 30087

Registration:
Jul 29, 2009
State ID:
09054399
Business type:
Domestic Professional Corporation
Secretary:
Sonia Juhan (Secretary), PO Box 1104, Gray, GA 31032 (Physical)
Agent:
Vernon Roberts,416 Waterfall Ln Stone Mtn Ga, Stone Mountain, GA 30087 (Physical)

Managed Care Organizations licenses in Georgia






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