| East Crogan Dental Group Pc | |
|
168 E Crogan St Lawrenceville GA 30046-4950 | |
| (678) 407-2803 | |
| Not Available |
| Full Name | East Crogan Dental Group Pc |
|---|---|
| Speciality | Dentist |
| Location | 168 E Crogan St, Lawrenceville, Georgia |
| Authorized Official Name and Position | Marie Dominique Saturne (OWNER) |
| Authorized Official Contact | 6784072803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Crogan Dental Group Pc Po Box 1173 Lawrenceville GA 30046-1173 Ph: (678) 407-2803 | East Crogan Dental Group Pc 168 E Crogan St Lawrenceville GA 30046-4950 Ph: (678) 407-2803 |
| NPI Number | 1568841856 |
|---|---|
| Provider Enumeration Date | 05/20/2015 |
| Last Update Date | 05/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568841856 | NPI | - | NPPES |
| 856863952A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN013248 (Georgia) | Primary |
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