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Organization
ELITE DENTAL MANAGEMENT INC
Active
Organization
ELITE DENTAL MANAGEMENT INC
Active
Other names
Riverside Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIN PARK DMD (DENTIST/OWNER)
(770) 879-1200
Entity
Organization
Contact information
Practice address
2100 RIVERSIDE PKWY STE 130, LAWRENCEVILLE, GA 30043-5914
(770) 822-3400
Mailing address
2100 RIVERSIDE PKWY STE 130, LAWRENCEVILLE, GA 30043-5914
(770) 822-3400
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/29/2025
Last updated
06/18/2025
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