Individual provider · Type 1 NPI
Gordon Cleland Fraser Jr., DMD
Periodontics · Conyers, GA
NPI number
1306034871
Active
Practice location
1916 Iris Drive
Conyers, GA 30094
Fax (770) 922-0401
Mailing address
P.o. Box 2213
Peachtree City, GA 30269
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | DN012684 (GA) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
About NPI 1306034871
Gordon Cleland Fraser Jr., DMD's National Provider Identifier is 1306034871, issued on Oct 10, 2007. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Conyers, GA. The record was last updated on May 3, 2016.