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General NPI Number Information
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NPI Number | 1295603678
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Entity Type | Organization
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Legal Business Name | GEORGIA BRACES FORSYTH LLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 156 N. LEE ST.
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City | FORSYTH
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State | GA
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Zip | 31029
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Country | US
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Telephone | 770-319-8220
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Fax |
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Provider Business Mailing Address
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Address Line | 156 N. LEE ST.
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City | FORSYTH
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State | GA
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Zip | 31029
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAMEON FISHER
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Credential | DDS
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Telephone | 770-319-8220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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