| Professional Dental Alliance Of Georgia, Llc | |
|
3466 Cobb Pkwy Nw Ste 170 Acworth GA 30101-5768 | |
| (770) 203-1711 | |
| (404) 855-4104 |
| Full Name | Professional Dental Alliance Of Georgia, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3466 Cobb Pkwy Nw Ste 170, Acworth, Georgia |
| Authorized Official Name and Position | Andrew Matta (OWNER) |
| Authorized Official Contact | 7246982500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Of Georgia, Llc 11 S Mill St New Castle PA 16101-3680 Ph: () - | Professional Dental Alliance Of Georgia, Llc 3466 Cobb Pkwy Nw Ste 170 Acworth GA 30101-5768 Ph: (770) 203-1711 |
| NPI Number | 1861900946 |
|---|---|
| Provider Enumeration Date | 01/11/2018 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861900946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN013474 (Georgia) | Primary |
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