Gwinnett General Dentistry

NPI #1821259854 in Lilburn, Georgia

Provider Information

NPI Number: 1821259854
Entity Type: Organization
Organization Name: Gwinnett General Dentistry
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 23, 2008
Last Updated: Jun 23, 2008

Practice Location

Address: 3100 FIVE FORKS TRICKUM RD SW
Address 2: SUITE 201
City: Lilburn
State: Georgia
ZIP Code: 30047-1890
Phone: (770) 978-3292

Authorized Official

Name: DONNA LONG
Title: OFFICE MANAGER
Phone: (770) 978-3292

Specialties & Taxonomy Codes

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

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