Organization
COLTON DENTAL GROUP
Active
Other names
east west family dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA TARD (BUSINESS MANAGER)
(678) 384-1020
Entity
Organization
Contact information
Practice address
2495 EAST-WEST CONNECTOR, STE 60, AUSTELL, GA 30106
(678) 384-1020
Mailing address
2495 EAST-WEST CONNECTOR, STE 60, AUSTELL, GA 30106
(678) 384-1020
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN013527
GA
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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