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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

639 Beaver Ruin Rd NW
Ste A
Lilburn, GA 30047
Phone (678) 395-3443

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Lilburn, GA

All providers in Lilburn, GA · Oral and Maxillofacial Surgery (Dentist) in Georgia

Sources for this page

Verify at the official NPI Registry.