Organization
GWINNETT DENTAL CARE LAWRENCEVILLE LLC
Active
Other names
Gwinnett Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LONG PHUNG DMD (OWNER DENTIST)
(678) 520-7534
Entity
Organization
Contact information
Practice address
911 DULUTH HWY STE E2, LAWRENCEVILLE, GA 30043-5399
(678) 520-7534
Mailing address
301 PAPER WOODS DR, LAWRENCEVILLE, GA 30046-5366
(678) 520-7534
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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