Organization
WAYNE T. TADSEN DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE THEODORE TADSEN DMD (PRESIDENT, OWNER)
(770) 995-6215
Entity
Organization
Contact information
Practice address
102 GORDON ST, LAWRENCEVILLE, GA 30045-6910
(770) 995-6215
(770) 995-6263
Mailing address
102 GORDON ST, LAWRENCEVILLE, GA 30045-6910
(770) 995-6215
(770) 995-6263
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN008626
GA
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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