DR. Richard Peter Gangwisch, D.D.S.

NPI #1255355145 in Lilburn, Georgia

Provider Information

NPI Number: 1255355145
Entity Type: Individual
Name: DR. Richard Peter Gangwisch, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Jul 26, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 912 KILLIAN HILL RD SW
Address 2: SUITE 100
City: Lilburn
State: Georgia
ZIP Code: 30047-3138
Phone: (770) 923-3966

Specialties & Taxonomy Codes

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

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