Organization
ELITE DENTAL MANAGEMENT INC
Active
Other names
Riverside Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIN PARK DMD (DENTIST/OWNER)
(770) 879-1200
Entity
Organization
Contact information
Practice address
2100 RIVERSIDE PKWY STE 130, LAWRENCEVILLE, GA 30043-5914
(770) 822-3400
Mailing address
2100 RIVERSIDE PKWY STE 130, LAWRENCEVILLE, GA 30043-5914
(770) 822-3400
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/29/2025
Last updated
06/18/2025
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