Organization
ADVANCED CENTER OF COSMETIC DENTISTRY & IMPLANTOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH PAUL GARDNER DMD (GENERAL DENTIST)
(770) 564-9906
Entity
Organization
Contact information
Practice address
449 PLEASANT HILL RD, SUITE 101, LILBURN, GA 30047
(770) 564-9906
(770) 564-9907
Mailing address
449 PLEASANT HILL RD, SUITE 101, LILBURN, GA 30047
(770) 564-9906
(770) 564-9907
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN01162
GA
1223G0001X
General Practice Dentistry
DN14123
FL
Other
Enumeration date
08/14/2006
Last updated
08/22/2020
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