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DR. BRUCE RAYMOND BILLINGER DDS MS
Periodontics >> Dentist >> Dental ProvidersRegistrant NPI Number: 1336258284
Individual Registrant:DR. BRUCE RAYMOND BILLINGER DDS MS
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
2120 ROCKBRIDGE RD STONE MOUNTAIN, GA 30087 US
Tel: 770-413-4213 Fax: 770-413-4233
Tel: 770-413-4213 Fax: 770-413-4233
Contact information for business:
2120 ROCKBRIDGE RD STONE MOUNTAIN, GA 30087 US
Tel: 770-413-4213 Fax: 770-413-4233
Tel: 770-413-4213 Fax: 770-413-4233
Registration Information:
NPI: 1336258284
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223P0300X | Dental Providers Dentist Periodontics | GA | 11173 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 00631221B | GA | 05 |
