Provider Demographics
NPI:1033258819
Name:MITCHELL, GEORGE THURMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:THURMAN
Last Name:MITCHELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3973 ATLANTA HWY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-3752
Mailing Address - Country:US
Mailing Address - Phone:770-466-8040
Mailing Address - Fax:770-466-8240
Practice Address - Street 1:3973 ATLANTA HWY
Practice Address - Street 2:SUITE 600
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-3752
Practice Address - Country:US
Practice Address - Phone:770-466-8040
Practice Address - Fax:770-466-8240
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA89981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics