Organization
GA SPECIALTY DENTAL SERVICES II, PC
Active
Parent organization
GA SPECIALTY DENTAL SERVICES II, PC
Other names
Suwanee Pediatric Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
GA SPECIALTY DENTAL SERVICES II, PC
Authorized official
CHARLOTTE DASCH (DIRECTOR OF CRED AND PROV RELATIONS)
(504) 638-0303
Entity
Organization
Contact information
Practice address
1380 PEACHTREE INDUSTRIAL BLVD STE 150, SUWANEE, GA 30024-3795
(770) 614-8914
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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