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General NPI Number Information
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NPI Number | 1487701173
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Entity Type | Organization
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Legal Business Name | MAGUSIAK & MORGAN, LLP
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 663 S 9TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-4215
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Country | US
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Telephone | 770-227-9693
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Fax | 770-227-8078
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Provider Business Mailing Address
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Address Line | 663 S 9TH ST
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City | GRIFFIN
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State | GA
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Zip | 30224-4215
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Country | US
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Telephone | 770-227-9693
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Fax | 770-227-8078
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Authorized Official
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Title or Position | INSURANCE COORDINATOR
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Name | MRS. MARTHA J. RAWDIN
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Credential |
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Telephone | 770-227-9693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 010457
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License Number State | GA
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