Affordable Dentist Of Snellville Ga, LLC
Dentist in Snellville, GA. Organization (NPI-2).
NPI number1184095374
StatusActive
Last updated in NPPESOct 13, 2015
Details
- NPI
- 1184095374
- Entity type
- Organization (NPI-2)
- Legal business name
- Affordable Dentist Of Snellville Ga, LLC
- Organization subpart
- No
- Enumeration date
- Oct 13, 2015
- Last updated
- Oct 13, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DN010714 | GA | Yes |
Other names
- Snellville Family Dental (Doing Business As)
Practice location
2138 Scenic Hwy NSte D
Snellville, GA 30078-6106
Phone 770-985-2325
Mailing address
Po Box 191363Atlanta, GA 31119-1363
Authorized official
David Vickers
Owner
9123835784
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