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Organization
GWINNETT DENTAL CARE LAWRENCEVILLE LLC
Active
Organization
GWINNETT DENTAL CARE LAWRENCEVILLE LLC
Active
Other names
Gwinnett Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LONG PHUNG DMD (OWNER DENTIST)
(678) 520-7534
Entity
Organization
Contact information
Practice address
911 DULUTH HWY STE E2, LAWRENCEVILLE, GA 30043-5399
(678) 520-7534
Mailing address
301 PAPER WOODS DR, LAWRENCEVILLE, GA 30046-5366
(678) 520-7534
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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