Organization
LAKE PARK DENTAL GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IU LU (DENTIST)
(678) 637-3835
Entity
Organization
Contact information
Practice address
2300 LAKE PARK DR SE, STE #160, SMYRNA, GA 30080-4076
(770) 432-0783
Mailing address
2300 LAKE PARK DR SE, STE #160, SMYRNA, GA 30080-4076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/27/2014
Last updated
02/27/2014
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