Organization
SAGE DENTAL GROUP OF GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN CHANG DMD (CHIEF DENTAL DIRECTOR)
(561) 999-9650
Entity
Organization
Contact information
Practice address
4320 LAVISTA RD, SUITE C119, TUCKER, GA 30084
(678) 688-4811
(561) 431-8169
Mailing address
6600 CONGRESS AVE STE 150, BOCA RATON, FL 33487-1213
(678) 688-4811
(561) 431-8169
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/17/2017
Last updated
05/18/2023
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