| Dentistry For Children Of Suwanee, Llc | |
|
3855 Johns Creek Pkwy Ste D Suwanee GA 30024-1293 | |
| (678) 473-1199 | |
| (678) 473-1701 |
| Full Name | Dentistry For Children Of Suwanee, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3855 Johns Creek Pkwy Ste D, Suwanee, Georgia |
| Authorized Official Name and Position | Charles Coulter (PEDIATRIC DENTIST) |
| Authorized Official Contact | 7704731350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentistry For Children Of Suwanee, Llc 295 Country Club Dr Stockbridge GA 30281-7350 Ph: (770) 473-1350 | Dentistry For Children Of Suwanee, Llc 3855 Johns Creek Pkwy Ste D Suwanee GA 30024-1293 Ph: (678) 473-1199 |
| NPI Number | 1033410857 |
|---|---|
| Provider Enumeration Date | 11/10/2010 |
| Last Update Date | 11/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033410857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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