| Mall Of Georgia Dentistry | |
|
1905 Mall Of Georgia Blvd Ste 1 Buford GA 30519 | |
| (678) 714-6343 | |
| (678) 714-6345 |
| Full Name | Mall Of Georgia Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1905 Mall Of Georgia Blvd Ste 1, Buford, Georgia |
| Authorized Official Name and Position | Allison Vancil (OFFICE MANAGER) |
| Authorized Official Contact | 6787146343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mall Of Georgia Dentistry 1905 Mall Of Georgia Blvd Ste 1 Buford GA 30519 Ph: (678) 714-6343 | Mall Of Georgia Dentistry 1905 Mall Of Georgia Blvd Ste 1 Buford GA 30519 Ph: (678) 714-6343 |
| NPI Number | 1871943662 |
|---|---|
| Provider Enumeration Date | 06/13/2016 |
| Last Update Date | 05/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871943662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 012441 (Georgia) | Primary |
| 261QD0000X | Clinic/center - Dental | 012441 (Georgia) | Secondary |
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