Organization
CHILDREN AND TEEN DENTAL GROUP
Active
Parent organization
CHILDREN AND TEEN DENTAL GROUP
Other names
Elite Dentistry of Georgia
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN AND TEEN DENTAL GROUP
Authorized official
MISS NICOLE CARIDE (CREDENTIALING MGR)
(727) 784-2721
Entity
Organization
Contact information
Practice address
679 BALDWIN RD, CORNELIA, GA 30531-5768
(706) 744-1832
Mailing address
2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
(470) 207-3264
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
03/04/2025
Last updated
05/06/2025
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