Organization
PARK VILLAGE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY AHN (OFFICE MANAGER)
(770) 814-7791
Entity
Organization
Contact information
Practice address
2550 PLEASANT HILL RD, SUITE #115, DULUTH, GA 30096-4122
(770) 814-7791
(770) 814-7792
Mailing address
2550 PLEASANT HILL RD, SUITE #115, DULUTH, GA 30096-4122
(770) 814-7791
(770) 814-7792
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
012497
GA
1223G0001X
General Practice Dentistry
013551
GA
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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