| Ccsd-dacula, Llc | |
|
420 Dacula Rd Dacula GA 30019-2128 | |
| (770) 277-0800 | |
| Not Available |
| Full Name | Ccsd-dacula, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 420 Dacula Rd, Dacula, Georgia |
| Authorized Official Name and Position | Rachel Smallwood (OFFICE MANAGER) |
| Authorized Official Contact | 7709951957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccsd-dacula, Llc 420 Dacula Rd Dacula GA 30019-2128 Ph: (770) 277-0800 | Ccsd-dacula, Llc 420 Dacula Rd Dacula GA 30019-2128 Ph: (770) 277-0800 |
| NPI Number | 1932754223 |
|---|---|
| Provider Enumeration Date | 08/05/2019 |
| Last Update Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932754223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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