Organization
KDNGA LLC
Active
Other names
Kid's Dentistry of North Georgia
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY GREENE (FINANCE MANAGER)
(678) 450-7011
Entity
Organization
Contact information
Practice address
1207 SHERWOOD PARK DR NE, GAINESVILLE, GA 30501-3444
(678) 450-7011
(678) 971-4201
Mailing address
1207 SHERWOOD PARK DR NE, GAINESVILLE, GA 30501-3444
(678) 450-7011
(678) 971-4201
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003175666B
—
GA
01
—
1790049047
NPI
GA
01
—
1790985620
NPI
GA
05
—
801406612B
—
GA
Enumeration date
06/21/2021
Last updated
06/22/2021
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