Organization
LOCAL DENTAL PARTNERS, LLC
Active
Parent organization
LOCAL DENTAL PARTNERS, LLC
Other names
Walton Center for Family Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOCAL DENTAL PARTNERS, LLC
Authorized official
ASHLEY NICHELLE THOMAS (CREDENTIALING ADMINISTRATOR)
(770) 450-2030
Entity
Organization
Contact information
Practice address
4353 ATLANTA HIGHWAY SUITE. 300, LOGANVILLE, GA 30052
(770) 405-2030
Mailing address
4353 ATLANTA HWY STE 300, LOGANVILLE, GA 30052-3232
(770) 405-2030
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN013645
GA
Other
Enumeration date
06/02/2017
Last updated
07/14/2017
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