Phillip Wayne Bracken, DDS Valid NPI
Individual provider · General Practice Dentistry · Mableton, GA
- NPI
- 1477651198
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- DN008476 (GA)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2006-09-20
- Last updated
- 2007-07-08
Practice location
5345 Floyd Rd Sw, Suite M
Mableton, GA 30126-2270
(770) 944-8620