Heartland Dental Care of Georgia, P.c.

NPI #1790190056 in Woodstock, Georgia

Provider Information

NPI Number: 1790190056
Entity Type: Organization
Organization Name: Heartland Dental Care of Georgia, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: HEARTLAND DENTAL CARE OF GEORGIA, P.C.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 25, 2014
Last Updated: Jun 25, 2014

Practice Location

Address: 12201 HIGHWAY 92
Address 2: SUITE G/H
City: Woodstock
State: Georgia
ZIP Code: 30188-7140
Phone: (678) 348-6858

Authorized Official

Name: KENDRA WALKER
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-8312

Specialties & Taxonomy Codes

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

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