Children and Teen Dental Group

NPI #1255139432 in Cornelia, Georgia

Provider Information

NPI Number: 1255139432
Entity Type: Organization
Organization Name: Children and Teen Dental Group
Subpart: Yes (part of a larger organization)
Parent Organization: CHILDREN AND TEEN DENTAL GROUP
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 4, 2025
Last Updated: May 6, 2025

Practice Location

Address: 679 BALDWIN RD
City: Cornelia
State: Georgia
ZIP Code: 30531-5768
Phone: (706) 744-1832

Authorized Official

Name: MISS NICOLE CARIDE
Title: CREDENTIALING MGR
Phone: (727) 784-2721

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Dentist - General Practice — General Practice	1223G0001X	Primary

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