# GEORGIA DENTAL GROUP, PC

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

## Provider details

- **NPI number:** 1811371008
- **Authorized official:** JESSIE WINKLER (REVENUE CYCLE MANAGER)
- **Authorized official phone:** (717) 590-1513

## Contact information

- **Practice address:** 101 N POINTE BLVD, SUITE 202, LANCASTER, PA 17601-4108
- **Practice address phone:** (717) 590-1513
- **Mailing address:** PO BOX 782886, PHILADELPHIA, PA 19178-2886
- **Mailing address phone:** (717) 590-1513

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 07/17/2015
- **Last updated:** 07/17/2015