Organization
CHILDREN AND TEEN DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN SMITH (CEO)
(470) 750-4866
Entity
Organization
Contact information
Practice address
2119 HAMILTON CREEK PKWY STE 200, DACULA, GA 30019-3293
(770) 744-4581
Mailing address
2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
(470) 750-4866
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/30/2016
Last updated
07/07/2026
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