Organization
PBT DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA JOHNSON (CRO)
(941) 444-0558
Entity
Organization
Contact information
Practice address
590 S ENOTA DR NE STE 2, GAINESVILLE, GA 30501-2433
(770) 536-4471
(770) 534-2174
Mailing address
590 S ENOTA DR NE STE 2, GAINESVILLE, GA 30501-2433
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/18/2019
Last updated
07/21/2026
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