NPI 1003423039

Cedar Dental Clinical I, LLC

Organisation Orthodontics and Dentofacial Orthopedics Dentistry McDonough, GA

Practice location

Address: 119 Willow Ln, McDonough, GA 30253-6574
Phone: (678) 432-8505
Fax: (678) 432-9419
Mailing address: 6801 Governors Lake Pkwy STE 290, Peachtree Corners, GA 30071-1136

Authorised official

Name: Henry Rankin Dallam
Title: President
Phone: (770) 331-2529

Registered specialties

Orthodontics and Dentofacial Orthopedics Dentistry Primary

Dental Providers Taxonomy 1223X0400X

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Registry record

NPI: 1003423039
Entity type: Organization
NPI issued: 24 Sep 2020
Record last updated: 24 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.