# GANGWISCH DENTAL GROUP, L.L.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588849186
- **Authorized official:** DR. RICHARD GANGWISCH D.D.S. (MEMBER)
- **Authorized official phone:** (770) 923-3966

## Contact information

- **Practice address:** 912 KILLIAN HILL RD SW, SUITE 100, LILBURN, GA 30047-3138
- **Practice address phone:** (770) 923-3966
- **Mailing address:** 912 KILLIAN HILL RD SW, SUITE 100, LILBURN, GA 30047-3138
- **Mailing address phone:** (770) 923-3966

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DN008859 | GA | Yes |

## Other

- **Enumeration date:** 01/02/2008
- **Last updated:** 01/02/2008