Organization
NORTHEAST GEORGIA DENTAL GROUP
Active
Other names
BGW Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
ANN SORENSEN (DIRECTOR OF OPERATIONS)
(770) 532-4555
Entity
Organization
Contact information
Practice address
1205 FRIENDSHIP ROAD, BRASELTON, GA 30517
(770) 532-4555
(770) 536-8053
Mailing address
1215 VINE ST NE, GAINESVILLE, GA 30501-2535
(770) 532-4555
(770) 536-8053
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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