Organization
SAGE DENTAL GROUP OF GEORGIA, LLC
Active
Other names
Sage Dental of Kennesaw
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY ROARK DMD. MS (SVP & CHIEF CLINICAL OFFICER)
(561) 999-9650
Entity
Organization
Contact information
Practice address
1610 RIDENOUR BLVD NW STE 102103, KENNESAW, GA 30152-4484
(561) 999-9650
Mailing address
6600 CONGRESS AVE STE 150, BOCA RATON, FL 33487-1213
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/07/2023
Last updated
04/07/2023
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