Provider Demographics
NPI:1639874902
Name:GOLDEN ISLES DENTAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:GOLDEN ISLES DENTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MCDONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-265-0750
Mailing Address - Street 1:25 CORAL PARK WAY
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-3000
Mailing Address - Country:US
Mailing Address - Phone:912-265-0750
Mailing Address - Fax:
Practice Address - Street 1:25 CORAL PARK WAY
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-3000
Practice Address - Country:US
Practice Address - Phone:912-265-0750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty