Organization
AFFORDABLE DENTAL CARE , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAVEEN GUDIPATI DMD (DENTIST)
(770) 279-2020
Entity
Organization
Contact information
Practice address
3993 LAWRENCEVILLE HWY NW STE 100A, LILBURN, GA 30047-2831
(770) 279-2020
(770) 279-1222
Mailing address
3993 LAWRENCEVILLE HWY NW STE 100A, LILBURN, GA 30047-2831
(770) 279-2020
(770) 279-1222
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255510624
NPI
GA
01
—
1700080793
NPI
GA
Enumeration date
12/13/2017
Last updated
12/13/2017
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