Bentwater Cosmetic and Family Dentistry

Organization Active NPI General Practice Dentistry · Lithia Springs, GA

NPI 1154069391 · NPPES record last updated Jul 27, 2022

Key facts

NPI
1154069391
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
BENTWATER COSMETIC AND FAMILY DENTISTRY
Practice address
351 Thornton Rd Ste 101
Lithia Springs, GA 30122-1589
Phone
(770) 944-9755
Fax
(770) 944-1261
NPI assigned
May 26, 2022
Organization subpart
No

Authorized official

Name
Tiffany Threlkeld, DO
Title
Business Manager
Phone
(678) 499-3514

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

3742 Cedarcrest Rd
B104
Acworth, GA 30101
Phone (770) 944-9755

351 Thornton Rd
Ste 101
Lithia Springs, GA 30122
Phone (770) 944-9755

Specialties & licenses

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

Addresses

Primary practice location

351 Thornton Rd Ste 101
Lithia Springs, GA 30122-1589

Mailing address

351 Thornton Rd Ste 101
Lithia Springs, GA 30122-1589
Phone (770) 944-9755

Other practice location 1

3742 Cedarcrest rd
B104
Acworth, GA 30101
Phone (770) 944-9755

Other identifiers

IdentifierTypeStateIssuer
DN011428OtherGADENTAL LICENSE NUMBER

Other providers in Lithia Springs, GA

All providers in Lithia Springs, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.