Sage Dental Group of Georgia LLC

NPI #1164956157 in Tucker, Georgia

Provider Information

NPI Number: 1164956157
Entity Type: Organization
Organization Name: Sage Dental Group of Georgia LLC
Primary Specialty: Dentist
Enumeration Date: Apr 17, 2017
Last Updated: May 18, 2023

Practice Location

Address: 4320 LAVISTA RD
Address 2: SUITE C119
City: Tucker
State: Georgia
ZIP Code: 30084
Phone: (678) 688-4811

Authorized Official

Name: JONATHAN CHANG, DMD
Title: CHIEF DENTAL DIRECTOR
Phone: (561) 999-9650

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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