Georgia Dental Professionals, PC

NPI #1013388552 in Dacula, Georgia

Provider Information

NPI Number: 1013388552
Entity Type: Organization
Organization Name: Georgia Dental Professionals, PC
Subpart: Yes (part of a larger organization)
Parent Organization: GEORGIA DENTAL PROFESSIONALS, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 9, 2015
Last Updated: Oct 9, 2015

Practice Location

Address: 635 DACULA RD
Address 2: SUITE 105
City: Dacula
State: Georgia
ZIP Code: 30019-2102
Phone: (678) 271-0718

Authorized Official

Name: KENDRA WALKER
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-8312

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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