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DR. BRIAN A BAIN D.D.S.

>> Dentist >> Dental Providers

Registrant NPI Number: 1821316092

Individual Registrant:
DR. BRIAN A BAIN D.D.S.
Gender: M
Sole Proprietor

Location and contact information for practice:
831 DIXIE ST  CARROLLTON, GA 30117-4415 US
Tel: 770-832-9668  Fax: 678-601-1574

Contact information for business:
429 MITCHELL AVE  BOWDON, GA 30108-1405 US
Tel: 770-258-5516  Fax: 770-258-5517

Registration Information:
NPI: 1821316092
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
GADN014278

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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