Individual
DR. RICHARD PETER GANGWISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
912 KILLIAN HILL RD SW, SUITE 100, LILBURN, GA 30047-3138
(770) 923-3966
(770) 564-8617
Mailing address
912 KILLIAN HILL RD SW, SUITE 100, LILBURN, GA 30047-3138
(770) 923-3966
(770) 564-8617
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
30-015431
OH
1223G0001X
General Practice Dentistry
Primary
DN008859
GA
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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