Organization
PDA ORTHO SPECIALTY OF GEORGIA, LLC
Active
Organization
PDA ORTHO SPECIALTY OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HOWARD MA (CREDENTIALING SPECIALIST)
(757) 576-5479
Entity
Organization
Contact information
Practice address
3450 COBB PKWY NW STE 160, ACWORTH, GA 30101-8379
(770) 222-2322
Mailing address
11 S MILL ST STE 200, NEW CASTLE, PA 16101-3680
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/01/2019
Last updated
06/29/2026
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