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COMPREHENSIVE AESTHETIC & RESTORATIVE DENTISTRY LLC NPI 1023149507


NPI Information

NPI: 1023149507
Provider Name: COMPREHENSIVE AESTHETIC & RESTORATIVE DENTISTRY LLC

Doing Business As: DENTISTRY OF OLDE TOWNE

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
113 TOWNE LAKE PKWY
STE 110
WOODSTOCK, GA
ZIP 30188
Phone: (770) 928-3055
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COMPREHENSIVE AESTHETIC & RESTORATIVE DENTISTRY LLC is a general practice dentist in Woodstock, GA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. COMPREHENSIVE AESTHETIC & RESTORATIVE DENTISTRY LLC NPI is 1023149507. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Dentistry Of Olde Towne.

The provider's business location address is:

113 TOWNE LAKE PKWY
STE 110
WOODSTOCK, GA
ZIP 30188
Phone: (770) 928-3055
Fax: (770) 928-1255

The provider's authorized official is Christopher Lee Rautenstrauch .
The authorized official title is Owner Llc Member and has the following contact phone number (770) 928-3055.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice9445GEORGIANo
21223G0001XDentistGeneral PracticeDN012537GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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