Organization
OAK GROVE PEDIATRIC DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN CUTLER (SECRETARY)
(607) 743-9474
Entity
Organization
Contact information
Practice address
3744 LAVISTA RD, DECATUR, GA 30033-1045
(770) 934-3506
Mailing address
296 S MAIN ST STE 300, ALPHARETTA, GA 30009-1973
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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