| Dentistry Of Olde Towne | |
|
113 Towne Lake Pkwy Ste 110 Woodstock GA 30188 | |
| (770) 928-3055 | |
| (770) 928-1255 |
| Full Name | Dentistry Of Olde Towne |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 113 Towne Lake Pkwy, Woodstock, Georgia |
| Authorized Official Name and Position | Christopher Lee Rautenstrauch (OWNER LLC MEMBER) |
| Authorized Official Contact | 7709283055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentistry Of Olde Towne 113 Towne Lake Pkwy Ste 110 Woodstock GA 30188 Ph: (770) 928-3055 | Dentistry Of Olde Towne 113 Towne Lake Pkwy Ste 110 Woodstock GA 30188 Ph: (770) 928-3055 |
| NPI Number | 1023149507 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023149507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN012537 (Georgia) | Primary |
| 1223G0001X | Dentist - General Practice | 9445 (Georgia) | Secondary |
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