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Organization

SAGE DENTAL GROUP OF GEORGIA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CINDY ROARK DMD, MS (CHIEF CLINICAL OFFICER)
(561) 999-9650
Entity
Organization

Contact information

Practice address
2171 LAVISTA RD NE, ATLANTA, GA 30329-3915
(561) 999-9650
Mailing address
951 BROKEN SOUND PKWY NW STE 250, BOCA RATON, FL 33487-3506
(561) 999-9650

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
06/08/2021
Last updated
06/11/2021
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