Dentalwise, LLC
Dentist in Lithia Springs, GA. Organization (NPI-2).
NPI number1316366271
StatusActive
Last updated in NPPESApr 8, 2014
Details
- NPI
- 1316366271
- Entity type
- Organization (NPI-2)
- Legal business name
- Dentalwise, LLC
- Organization subpart
- No
- Enumeration date
- Apr 8, 2014
- Last updated
- Apr 8, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Practice location
2635 Lee Rd Ste C4Lithia Springs, GA 30122-3356
Phone 770-489-9141 · Fax 770-489-9138
Mailing address
2635 Lee Rd Ste C4Lithia Springs, GA 30122-3356
Phone 770-489-9141 · Fax 770-489-9138
Authorized official
Randall Little
Owner
7708539244
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