Organization
PCP DENTAL LLC
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LA DUC (PROVIDER RELATIONS)
(315) 454-6000
Entity
Organization
Contact information
Practice address
890 DAWSONVILLE HWY, STE F, GAINESVILLE, GA 30501-2607
(678) 928-3219
(770) 532-6391
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/02/2016
Last updated
12/02/2016
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