Organization
METADENT CLUB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL DOMINIQUE DMD (OWNER/DENTIST)
(770) 615-6155
Entity
Organization
Contact information
Practice address
3535 ROSWELL RD STE 53, MARIETTA, GA 30062-8828
(770) 615-6155
Mailing address
3535 ROSWELL RD STE 53, MARIETTA, GA 30062-8828
(770) 615-6155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/18/2026
Last updated
02/18/2026
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