Organization
GA SPECIALTY DENTAL SERVICES II, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE DASCH (DIRECTOR OF PROVIDER RELATIONS)
(504) 638-0303
Entity
Organization
Contact information
Practice address
3415 DULUTH HWY # 120, DULUTH, GA 30096-3354
(770) 623-8520
Mailing address
401 CHURCH ST STE 1400, NASHVILLE, TN 37219-2214
(504) 638-0303
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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