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Organization
GAINESVILLE DENTAL ASSOCIATES LLC
Active
Organization
GAINESVILLE DENTAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENKATADRI CHALASANI DMD (DENTIST)
(770) 718-9091
Entity
Organization
Contact information
Practice address
1216 AVIATION BLVD, SUITE 101, GAINESVILLE, GA 30501-6848
(770) 718-9091
Mailing address
1216 AVIATION BLVD, SUITE 101, GAINESVILLE, GA 30501-6848
(770) 718-9091
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN012993
GA
261QD0000X
Dental Clinic/Center
DN013184
GA
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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