| Loganville Dental Associates | |
|
3955 Harrison Rd Ste 400 Loganville GA 30052-8502 | |
| (770) 466-0580 | |
| (770) 466-1536 |
| Full Name | Loganville Dental Associates |
|---|---|
| Speciality | Clinic/Center |
| Location | 3955 Harrison Rd Ste 400, Loganville, Georgia |
| Authorized Official Name and Position | Hasan Syed (SOLE OWNER) |
| Authorized Official Contact | 4044317139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loganville Dental Associates 3955 Harrison Rd Ste 400 Loganville GA 30052-8502 Ph: (770) 466-0580 | Loganville Dental Associates 3955 Harrison Rd Ste 400 Loganville GA 30052-8502 Ph: (770) 466-0580 |
| NPI Number | 1669910659 |
|---|---|
| Provider Enumeration Date | 02/09/2017 |
| Last Update Date | 04/02/2024 |
| Medicare PECOS PAC ID | 0547607079 |
|---|---|
| Medicare Enrollment ID | O20240411002505 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669910659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN014452 (Georgia) | Primary |
| Provider Name | Hasan Ali Syed |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1801142880 PECOS PAC ID: 2365889896 Enrollment ID: I20240411002636 |
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