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Organization
COLTON DENTAL GROUP
Active
Organization
COLTON DENTAL GROUP
Active
Other names
east west family dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA TARD (BUSINESS MANAGER)
(678) 384-1020
Entity
Organization
Contact information
Practice address
2495 EAST-WEST CONNECTOR, STE 60, AUSTELL, GA 30106
(678) 384-1020
Mailing address
2495 EAST-WEST CONNECTOR, STE 60, AUSTELL, GA 30106
(678) 384-1020
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN013527
GA
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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