Georgia Dental Professionals, PC
Organization Active NPI General Practice Dentistry · Tyrone, GA
NPI 1962098210 · NPPES record last updated Dec 21, 2020
Key facts
- NPI
- 1962098210
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- GEORGIA DENTAL PROFESSIONALS, PC
- Practice address
- 1522 Highway 74 N
Tyrone, GA 30290-1663 - Phone
- (678) 788-8050
- NPI assigned
- Dec 21, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- GEORGIA DENTAL PROFESSIONALS, PC
Authorized official
- Name
- Tabatha Lemke
- Title
- Credentialing Coordinator
- Phone
- (217) 540-6078
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 16
National Provider Directory
- Tax ID family
- Georgia Dental Professionals PC
- Part of
- Georgia Dental Professionals PC
Locations
1522 Highway 74 N
Tyrone, GA 30290
Phone (404) 784-1941
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
1522 Highway 74 N
Tyrone, GA 30290-1663
Mailing address
1522 Highway 74 N
Tyrone, GA 30290-1663
Other names
- Tyrone Family Dentistry
Other providers in Tyrone, GA
- Gened Psych Associates, LLC
- Genesys Family Practice, Inc.
- Genesys GYN Inc
- Genesys OB/GYN, LLC
- Georgia CVS Pharmacy, L.L.C.
- Georgia Integrative Medicine
- Georgia Rheumatology Clinic PC
- Jana Gills
- Debra J Gray
- Nekeia Gray
All providers in Tyrone, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2020. 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.