Organization
GEORGIA DENTAL PROFESSIONALS, PC
Active
Parent organization
GEORGIA DENTAL PROFESSIONALS, PC
Other names
Suwanee Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Authorized official
KENDRA WALKER (CREDENTIALING TEAM LEAD)
(217) 540-8312
Entity
Organization
Contact information
Practice address
4355 SUWANEE DAM RD, SUWANEE, GA 30024-6707
(770) 614-7300
(770) 614-7911
Mailing address
4355 SUWANEE DAM RD, SUWANEE, GA 30024-6707
(770) 614-7300
(770) 614-7911
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/29/2012
Last updated
11/07/2016
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