Organization
COMPREHENSIVE DENTAL CENTER
Active
Other names
Lilburn Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KETANKUMAR PATEL D.M.D. (OWNER)
(770) 925-4773
Entity
Organization
Contact information
Practice address
629 BEAVER RUIN RD NW, SUITE A, LILBURN, GA 30047-3401
(770) 925-4773
(770) 925-8773
Mailing address
629 BEAVER RUIN RD NW, SUITE A, LILBURN, GA 30047-3401
(770) 925-4773
(770) 925-8773
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN012835
GA
Other
Enumeration date
10/01/2007
Last updated
10/01/2007
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