Organization
ATLANTA WEST PERIODNTICS AND DENTAL IMPLANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHUONG THAO TRAN NGUYEN DDS, MSD (PRESIDENT)
(832) 566-7358
Entity
Organization
Contact information
Practice address
2168 SKYVIEW DR, LITHIA SPRINGS, GA 30122-2638
(770) 739-5097
Mailing address
2168 SKYVIEW DR, LITHIA SPRINGS, GA 30122-2638
(770) 739-5097
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
01/02/2023
Last updated
01/02/2023
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