Canton Dental, LLC

NPI #1841524295 in Canton, Georgia

Provider Information

NPI Number: 1841524295
Entity Type: Organization
Organization Name: Canton Dental, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 1, 2009
Last Updated: Oct 1, 2009

Practice Location

Address: 230 RIVERSTONE PKWY STE A
City: Canton
State: Georgia
ZIP Code: 30114-6414
Phone: (770) 479-5425

Authorized Official

Name: DR. LOGAN V GORDON
Title: BUSINESS MANAGER
Phone: (770) 479-5425

Specialties & Taxonomy Codes

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

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