Organization
R JASON NEIL BONGIOVI DMD PC
Active
Other names
Pediatric Dentistry of Forsyth
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON NEIL BONGIOVI DMD (PRESIDENT)
(404) 316-0588
Entity
Organization
Contact information
Practice address
3810 WINDEMERE PARKWAY, STE 502, CUMMING, GA 30041
(404) 316-0588
Mailing address
18 VERNON GLEN CT, ATLANTA, GA 30338-5420
(404) 316-0588
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN013085
GA
Other
Enumeration date
02/11/2009
Last updated
02/11/2009
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