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Georgia Dental Professionals, PC

Organization Active NPI General Practice Dentistry · Gainesville, GA

NPI 1922409945 · NPPES record last updated Sep 9, 2014

Key facts

NPI
1922409945
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
GEORGIA DENTAL PROFESSIONALS, PC
Practice address
615 Green St NW
Gainesville, GA 30501-3378
Phone
(770) 532-2336
Fax
(770) 536-3905
NPI assigned
Sep 9, 2014
Organization subpart
Yes
Parent organization (as reported)
GEORGIA DENTAL PROFESSIONALS, PC

Authorized official

Name
Kim Wilson
Title
Cred Supervisor
Phone
(217) 540-5170

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 19

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Georgia Dental Professionals PC (72 organizations share this tax ID)
Part of
Georgia Dental Professionals PC

Locations

615 Green St NW
Gainesville, GA 30501

Specialties & licenses

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

Addresses

Primary practice location

615 Green St NW
Gainesville, GA 30501-3378

Mailing address

615 Green St NW
Gainesville, GA 30501-3378
Phone (770) 532-2336

Other names

  • Green Street Smiles Doing business as

Other providers in Gainesville, GA

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

Sources for this page

Verify at the official NPI Registry.