Aesthetic Dental Assoc of NE Ga LLC

NPI #1457793895 in Bogart, Georgia

Provider Information

NPI Number: 1457793895
Entity Type: Organization
Organization Name: Aesthetic Dental Assoc of NE Ga LLC
Primary Specialty: Dentist
Enumeration Date: Jul 26, 2013
Last Updated: Jul 26, 2013

Practice Location

Address: 1520A JENNINGS MILL RD
City: Bogart
State: Georgia
ZIP Code: 30622-2543
Phone: (706) 353-1958

Authorized Official

Name: R. LAWRENCE GEORGE, DMD
Title: OWNER
Phone: (706) 353-1958

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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