PATRIOTS PARK DENTAL NPI 1689002610

NPI Information

  • NPI: 1689002610
  • Provider Name: PATRIOTS PARK DENTAL
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 2054 WARRIOR WAY
    GROVETOWN, GA
    ZIP 30813
  • Phone: (706) 664-0744

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NPI Details

PATRIOTS PARK DENTAL is a general practice dentist in Grovetown, 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. PATRIOTS PARK DENTAL NPI is 1689002610. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2054 WARRIOR WAY
GROVETOWN, GA
ZIP 30813-132
Phone: (706) 664-0744
Fax: (706) 664-0747

The provider's authorized official is Thomas Moreno .
The authorized official title is Owner and has the following contact phone number (706) 664-0744.

The enumeration date for this NPI number is 10/30/2013 and was last updated on 6/17/2024.

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
2332BC3200XDurable Medical Equipment & Medical SuppliesCustomized EquipmentNo

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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