FAYETTEVILLE PEDIATRIC DENTISTRY is a pediatric dentistry dentist in Fayetteville, GA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. FAYETTEVILLE PEDIATRIC DENTISTRY NPI is 1073056933. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
320 N JEFF DAVIS DR
SUITE C
FAYETTEVILLE, GA
ZIP 30214-669
Phone: (770) 651-1000
The provider's authorized official is Vishant Nath .
The authorized official title is Dentist and has the following contact phone number (770) 651-1000.
The CLIA number assigned to this NPI record is 11D0952596 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 11/28/2016 and was last updated on 11/28/2016.