Robert Lawrence George, DMD
Individual provider Active NPI Dentist · Bogart, GA
NPI 1124121165 · NPPES record last updated Feb 10, 2010
Key facts
- NPI
- 1124121165
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DN007721 (GA)
- Practice address
- 1520-A Jennings Mill Road
Bogart, GA 30622-2543 - Phone
- (706) 353-1958
- Fax
- (706) 353-3939
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN007721 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aesthetic Dental Assoc of NE Ga LLC | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN007721 | GA | Yes |
Addresses
Primary practice location
1520-A Jennings Mill Road
Bogart, GA 30622-2543
Mailing address
1520-A Jennings Mill Road
Bogart, GA 30622-2543
Phone (706) 353-1958
Other providers in Bogart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.