Organization
VITA DENTISTRY, LLC
Active
Other names
Biologic Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW VITA DMD (OWNER)
(770) 426-9994
Entity
Organization
Contact information
Practice address
1781 BROOKSTONE WALK NW STE 110, ACWORTH, GA 30101-7223
(770) 426-9994
(770) 426-0833
Mailing address
1781 BROOKSTONE WALK NW STE 110, ACWORTH, GA 30101-7223
(770) 426-9994
(770) 426-0833
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528146750
INDIVIDUAL NPI
GA
01
—
1588216261
INDIVIDUAL NPI
GA
Enumeration date
12/03/2024
Last updated
12/03/2024
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