Suwanee Station Dentistry, LLC

NPI #1043530686 in Suwanee, Georgia

Provider Information

NPI Number: 1043530686
Entity Type: Organization
Organization Name: Suwanee Station Dentistry, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 6, 2010
Last Updated: Jun 6, 2010

Practice Location

Address: 1300 PEACHTREE INDUSTRIAL BLVD
Address 2: SUITE 4103
City: Suwanee
State: Georgia
ZIP Code: 30024-4539
Phone: (770) 831-5568

Authorized Official

Name: TARA PERRY
Title: DENTIST
Phone: (770) 831-5568

Specialties & Taxonomy Codes

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

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