Aesthetic Dental Assoc of NE Ga LLC
Organization Active NPI Dentist · Bogart, GA
NPI 1457793895 · NPPES record last updated Jul 26, 2013
Key facts
- NPI
- 1457793895
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- DN007721 (GA)
- Legal business name
- AESTHETIC DENTAL ASSOC OF NE GA LLC
- Practice address
- 1520A Jennings Mill Rd
Bogart, GA 30622-2543 - Phone
- (706) 353-1958
- Fax
- (706) 353-3939
- NPI assigned
- Jul 26, 2013
- Organization subpart
- No
Authorized official
- Name
- R. Lawrence George, DMD
- Title
- Owner
- Phone
- (706) 353-1958
Practitioners 2
-
William F. Morang, D.M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | DN007721 | GA | Yes |
Addresses
Primary practice location
1520A Jennings Mill Rd
Bogart, GA 30622-2543
Mailing address
1520A Jennings Mill Rd
Bogart, GA 30622-2543
Phone (706) 353-1958
Other providers in Bogart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2013. 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.