# GOVERNMENT DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elite Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528422524
- **Authorized official:** MRS. FRANCINE WEATHERSPOON DIXON (CEO)
- **Authorized official phone:** (865) 256-2638

## Contact information

- **Practice address:** 7218 HIGHWAY 85, RIVERDALE, GA 30274-2908
- **Practice address phone:** (404) 593-3404
- **Practice address fax:** (404) 228-9673
- **Mailing address:** 7218 HIGHWAY 85, RIVERDALE, GA 30274-2908
- **Mailing address phone:** (404) 593-3404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 14566GA | GA | Yes |

## Other

- **Enumeration date:** 04/06/2016
- **Last updated:** 05/23/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003180284A | — | GA |