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Organization
VAN DERHEI IMPLANT AND PROSTHETICS
Active
Organization
VAN DERHEI IMPLANT AND PROSTHETICS
Active
Other names
VIP Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK VAN DERHEI DDS, MSD (DENTIST)
(678) 318-3353
Entity
Organization
Contact information
Practice address
3590 BRASELTON HWY, STE 103, DACULA, GA 30019-1117
(678) 318-3353
(678) 318-3350
Mailing address
3590 BRASELTON HWY, STE 103, DACULA, GA 30019-1117
(678) 318-3353
(678) 318-3350
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN011854
GA
261QD0000X
Dental Clinic/Center
DN012702
GA
Other
Enumeration date
01/05/2011
Last updated
07/19/2012
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