Organization
DENTAL NATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YEN TRAN DMD (CEO)
(404) 644-5963
Entity
Organization
Contact information
Practice address
4343 S MAIN ST, ACWORTH, GA 30101-5542
(404) 644-5963
Mailing address
589 AUBURN AVE NE UNIT A, ATLANTA, GA 30312-1990
(404) 644-5963
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508206046
DENTAL
GA
Enumeration date
09/11/2018
Last updated
09/11/2018
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