Organization
SUWANEE STATION DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA PERRY (DENTIST)
(770) 831-5568
Entity
Organization
Contact information
Practice address
1300 PEACHTREE INDUSTRIAL BLVD, SUITE 4103, SUWANEE, GA 30024-4539
(770) 831-5568
(770) 831-5527
Mailing address
1300 PEACHTREE INDUSTRIAL BLVD, SUITE 4103, SUWANEE, GA 30024-4539
(770) 831-5568
(770) 831-5527
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012548
GA
Other
Enumeration date
06/06/2010
Last updated
06/06/2010
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