Dentalwise, Llc | |
2635 Lee Rd Ste C4 Lithia Springs GA 30122-3356 | |
(770) 489-9141 | |
(770) 489-9138 |
Full Name | Dentalwise, Llc |
---|---|
Speciality | Dentist |
Location | 2635 Lee Rd Ste C4, Lithia Springs, Georgia |
Authorized Official Name and Position | Randall Little (OWNER) |
Authorized Official Contact | 7708539244 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dentalwise, Llc 2635 Lee Rd Ste C4 Lithia Springs GA 30122-3356 Ph: (770) 489-9141 | Dentalwise, Llc 2635 Lee Rd Ste C4 Lithia Springs GA 30122-3356 Ph: (770) 489-9141 |
NPI Number | 1316366271 |
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Provider Enumeration Date | 04/08/2014 |
Last Update Date | 04/08/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316366271 | NPI | - | NPPES |
003141558A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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