Gwinnett Family Dentistry LLC

NPI #1104167865 in Lilburn, Georgia

Provider Information

NPI Number: 1104167865
Entity Type: Organization
Organization Name: Gwinnett Family Dentistry LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 6, 2013
Last Updated: Mar 6, 2013

Practice Location

Address: 504 INDIAN TRAIL LILBURN RD NW
Address 2: SUITE 100
City: Lilburn
State: Georgia
ZIP Code: 30047-3720
Phone: (770) 921-5100

Authorized Official

Name: CARLOS FERNANDO BARRIONUEVO
Title: CEO
Phone: (770) 921-5100

Specialties & Taxonomy Codes

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

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