NPI 1053739979

Ga Dentistry Services PC

Organisation General Practice Dentistry McDonough, GA

Practice location

Address: 1430 Highway 20 W, McDonough, GA 30253-7305
Phone: (678) 537-6000
Mailing address: PO Box 3189, Syracuse, NY 13220-3189

Authorised official

Name: Candace Lauderdale
Title: Dmd/Incorporator
Phone: (315) 454-6000

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 13892 (GA)

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Registry record

NPI: 1053739979
Entity type: Organization
NPI issued: 29 Mar 2014
Record last updated: 29 Mar 2014

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.