NORTHEAST GEORGIA DENTAL PROFESSIONALS LLC NPI 1093283715

NPI Information

NORTHEAST GEORGIA DENTAL PROFESSIONALS, LLC is a general practice dentist in Dacula, 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. NORTHEAST GEORGIA DENTAL PROFESSIONALS, LLC NPI is 1093283715. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2700 BRASELTON HWY STE 12
DACULA, GA
ZIP 30019-263
Phone: (770) 932-4240

The provider's authorized official is Eric Jones .
The authorized official title is Ceo and has the following contact phone number (770) 932-4240.

The CLIA number assigned to this NPI record is 11D1104837 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/12/2018 and was last updated on 11/12/2018.

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:

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