Organization
CHILDREN'S DENTISTRY OF LITHONIA, LLC
Active
Parent organization
CHILDREN'S DENTISTRY OF LITHONIA, LLC
Other names
Children's Dentistry of Lawrenceville
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S DENTISTRY OF LITHONIA, LLC
Authorized official
MR. ADESEGUN OLUSHOLA TEWOGBADE DMD (PEDIATRIC DENTIST/OWNER)
(770) 584-5267
Entity
Organization
Contact information
Practice address
4850 SUGARLOAF PARKWAY, STE 611, LAWRENCEVILLE, GA 30044
(470) 299-3999
(678) 691-9589
Mailing address
4850 SUGARLOAF PARKWAY, STE 611, LAWRENCEVILLE, GA 30044
(470) 299-3999
(678) 691-9589
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN013400
GA
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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