MDG - MCDONOUGH DENTAL LLC NPI 1417782707

NPI Information

  • NPI: 1417782707
  • Provider Name: MDG - MCDONOUGH DENTAL LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 97 ATLANTA ST STE 200
    MCDONOUGH, GA
    ZIP 30253
  • Phone: (770) 954-7780

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NPI Details

MDG - MCDONOUGH DENTAL LLC is a general practice dentist in Mcdonough, 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. MDG - MCDONOUGH DENTAL LLC NPI is 1417782707. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

97 ATLANTA ST STE 200
MCDONOUGH, GA
ZIP 30253-192
Phone: (770) 954-7780
Fax: (770) 954-1640

The provider's authorized official is Robert Kellen Mcwhorter .
The authorized official title is Dentist and has the following contact phone number (801) 358-8175.

The enumeration date for this NPI number is 9/5/2024 and was last updated on 9/5/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

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: 11/21/2025

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