Organization
GWINNETT FAMILY DENTISTRY LLC
Active
Other names
Gwinnett Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS FERNANDO BARRIONUEVO (CEO)
(770) 921-5100
Entity
Organization
Contact information
Practice address
504 INDIAN TRAIL LILBURN RD NW, SUITE 100, LILBURN, GA 30047-3720
(770) 921-5100
Mailing address
504 INDIAN TRAIL LILBURN RD NW, SUITE 100, LILBURN, GA 30047-3720
(770) 921-5100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
GA
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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