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Organization
GOCD LAWRENCEVILLE LLC
Active
Organization
GOCD LAWRENCEVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN CHONG DMD (MANAGING MEMBER)
(770) 854-2424
Entity
Organization
Contact information
Practice address
2087 CRUSE RD STE B, LAWRENCEVILLE, GA 30044-2345
(770) 845-2424
(706) 558-3909
Mailing address
2087 CRUSE RD STE B, LAWRENCEVILLE, GA 30044-2345
(770) 845-2424
(706) 558-3909
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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