AVALA DENTAL PROVIDERSLLC NPI 1851729883

NPI Information

AVALA DENTAL PROVIDERS,LLC is a point of service in Lilburn, GA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. AVALA DENTAL PROVIDERS,LLC NPI is 1851729883. The provider is registered as an organization entity type.
The provider Is Doing Business As Polish Dental Center,llc.

The provider's business location address is:

629 A BEAVER RUIN RD
LILBURN, GA
ZIP 30047
Phone: (770) 696-4144
Fax: (470) 545-2859

The provider's authorized official is Tiffany N Jamison .
The authorized official title is Owner and has the following contact phone number (770) 696-4144.

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

Taxonomy Codes

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Other Identifiers

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