Organization
LAWRENCEVILLE DENTAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETHE TRALONGO DDS (OWNER)
(404) 537-5211
Entity
Organization
Contact information
Practice address
171 GWINNETT DRIVE, SUITE C, LAWRENCEVILLE, GA 30046
(770) 913-1941
Mailing address
999 PEACHTREE STREET, NE, SUITE 800, ATLANTA, GA 30309
(404) 537-5211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0011999
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033258868
NPI
GA
01
—
1265634638
NPI
GA
01
—
1750585147
NPI
GA
01
—
1891904538
NPI
GA
Enumeration date
11/29/2007
Last updated
12/29/2017
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