Alan C. Tucker, D.D.S., P.C.
Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · Lilburn, GA
NPI 1104904036 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1104904036
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 10864 (GA)
- Legal business name
- ALAN C. TUCKER, D.D.S., P.C.
- Practice address
- 639A Beaver Ruin Rd NW
Lilburn, GA 30047-3401 - Phone
- (770) 923-5200
- Fax
- (770) 564-0613
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Alan Charles Tucker, D.D.S.
- Title
- President
- Phone
- (770) 923-5200
Practitioners 1
-
Alan Charles Tucker, D.D.S.
National Provider Directory
Locations
639 Beaver Ruin Rd NW
Ste A
Lilburn, GA 30047
Phone (678) 395-3443
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | 10864 | GA | Yes |
Addresses
Primary practice location
639A Beaver Ruin Rd NW
Lilburn, GA 30047-3401
Mailing address
639A Beaver Ruin Rd NW
Lilburn, GA 30047-3401
Phone (770) 923-5200
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All providers in Lilburn, GA · Oral and Maxillofacial Surgery (Dentist) in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.