# SAGE DENTAL GROUP OF GEORGIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sage Dental of McDonough
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538922695
- **Authorized official:** DR. CINDY ROARK (SVP & CHIEF CLINICAL OFFICER)
- **Authorized official phone:** (561) 999-9650

## Contact information

- **Practice address:** 2382 JONESBORO RD, MCDONOUGH, GA 30228
- **Practice address phone:** (561) 999-9650
- **Mailing address:** PO BOX 931622, ATLANTA, GA 31193-1622

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 02/01/2024
- **Last updated:** 02/01/2024