Provider Demographics
NPI:1548755929
Name:BRINSON, BILLY CLIFFORD JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:CLIFFORD
Last Name:BRINSON
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 BELL RD
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-4258
Mailing Address - Country:US
Mailing Address - Phone:478-494-2988
Mailing Address - Fax:
Practice Address - Street 1:265 HOPKINS CORNER DR
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:GA
Practice Address - Zip Code:30830-3448
Practice Address - Country:US
Practice Address - Phone:478-494-2988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0156901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice