Organization
NORTHEAST GEORGIA DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD G. BENNETT (OWNER)
(770) 532-4555
Entity
Organization
Contact information
Practice address
1200 SHERWOOD PARK DR NE, GAINESVILLE, GA 30501-3445
(770) 532-4555
Mailing address
1200 SHERWOOD PARK DR NE, GAINESVILLE, GA 30501-3445
(770) 532-4555
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN011850
GA
Other
Enumeration date
05/09/2007
Last updated
10/19/2011
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