Provider Demographics
NPI:1548393200
Name:TALBOT, GEORGE MURRAY JR (DDS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:MURRAY
Last Name:TALBOT
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 BLUE RIDGE OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4431
Mailing Address - Country:US
Mailing Address - Phone:706-946-5602
Mailing Address - Fax:706-374-7628
Practice Address - Street 1:990 E MAIN ST
Practice Address - Street 2:SUITE 11
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-4565
Practice Address - Country:US
Practice Address - Phone:706-258-3384
Practice Address - Fax:706-374-7628
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007256122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00048562DMedicaid