| Oak Grove Pediatric Dentistry, P.c. | |
|
3744 Lavista Rd Decatur GA 30033-1045 | |
| (770) 934-3506 | |
| Not Available |
| Full Name | Oak Grove Pediatric Dentistry, P.c. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3744 Lavista Rd, Decatur, Georgia |
| Authorized Official Name and Position | Ben Cutler (SECRETARY) |
| Authorized Official Contact | 6077439474 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Grove Pediatric Dentistry, P.c. 296 S Main St Ste 300 Alpharetta GA 30009-1973 Ph: () - | Oak Grove Pediatric Dentistry, P.c. 3744 Lavista Rd Decatur GA 30033-1045 Ph: (770) 934-3506 |
| NPI Number | 1942083852 |
|---|---|
| Provider Enumeration Date | 08/15/2023 |
| Last Update Date | 08/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942083852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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