Organization
CW DENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN CHONG DMD (OWNER)
(404) 512-9355
Entity
Organization
Contact information
Practice address
13075 HIGHWAY 9 N, SUITE 110, MILTON, GA 30004-5145
(404) 512-9355
Mailing address
10420 SUGAR CREST AVE, DULUTH, GA 30097-7889
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN014085
GA
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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