Centre Of Panola Cosmetic & Family Dentistry P.C.
Dentist, General Practice in Lithonia, GA. Organization (NPI-2).
NPI number1942021555
StatusActive
Last updated in NPPESOct 17, 2024
Details
- NPI
- 1942021555
- Entity type
- Organization (NPI-2)
- Legal business name
- Centre Of Panola Cosmetic & Family Dentistry P.C.
- Organization subpart
- No
- Enumeration date
- Oct 17, 2024
- Certification date
- Oct 17, 2024
- Last updated
- Oct 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
3035 Panola Rd Ste ALithonia, GA 30038-2494
Phone 770-498-3744
Mailing address
3035 Panola Rd Ste ALithonia, GA 30038-2494
Phone 770-498-3744
Authorized official
Ida Lanier
President
7704983744
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