Organization
PONCE DENTAL STUDIO MCDONOUGH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK NIA (OWNER)
(770) 312-9897
Entity
Organization
Contact information
Practice address
500 PLAZA PKWY STE 496498, MCDONOUGH, GA 30253-6146
(404) 777-4040
(404) 474-8733
Mailing address
500 PLAZA PKWY STE 496498, MCDONOUGH, GA 30253-6146
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/28/2026
Last updated
01/28/2026
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