American Dental of Lagrange, LLC

Organization Active NPI General Practice Dentistry · Lagrange, GA

NPI 1114129343 · NPPES record last updated Dec 6, 2016

Key facts

NPI
1114129343
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
AMERICAN DENTAL OF LAGRANGE, LLC
Practice address
313 Mooty Bridge Road
Lagrange, GA 30240
Phone
(706) 837-0123
Fax
(706) 668-5100
NPI assigned
Jun 1, 2007
Organization subpart
No

Authorized official

Name
Dr. Michael Alan Knight, DMO
Title
DDS
Phone
(706) 837-0123

Practitioners 2

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

National Provider Directory

Locations

313 Mooty Bridge Rd
Lagrange, GA 30240
Phone (706) 837-0123

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

313 Mooty Bridge Road
Lagrange, GA 30240

Mailing address

P.O Box 457
Eastman, GA 31023
Phone (478) 290-7340

Other providers in Lagrange, GA

All providers in Lagrange, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.