Organization
GEORGIA DENTAL GROUP OF GA LLC
Active
Other names
Elite Dentistry of Georgia, Elite Dentistry of Habersham
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE CARIDE (CREDENTIALING MANAGER)
(727) 784-2721
Entity
Organization
Contact information
Practice address
679 BALDWIN RD, CORNELIA, GA 30531-5768
(706) 778-7147
Mailing address
2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
(470) 207-3264
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/14/2024
Last updated
01/20/2025
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