Organization
VAN DERHEI IMPLANT AND PROSTHETICS
Active
Other names
VIP Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK VAN DERHEI DDS, MSD (DENTIST)
(678) 318-3353
Entity
Organization
Contact information
Practice address
3590 BRASELTON HWY, STE 103, DACULA, GA 30019-1117
(678) 318-3353
(678) 318-3350
Mailing address
3590 BRASELTON HWY, STE 103, DACULA, GA 30019-1117
(678) 318-3353
(678) 318-3350
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN011854
GA
261QD0000X
Dental Clinic/Center
DN012702
GA
Other
Enumeration date
01/05/2011
Last updated
07/19/2012
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