| Shadow Brook Dental Care | |
|
3320 Lawrenceville Suwanee Rd Suite 2f Suwanee GA 30024-6542 | |
| (678) 546-4000 | |
| (678) 546-4005 |
| Full Name | Shadow Brook Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3320 Lawrenceville Suwanee Rd, Suwanee, Georgia |
| Authorized Official Name and Position | Kendra Walker (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 2175408312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shadow Brook Dental Care 3320 Lawrenceville Suwanee Rd Suite 2f Suwanee GA 30024-6542 Ph: (678) 546-4000 | Shadow Brook Dental Care 3320 Lawrenceville Suwanee Rd Suite 2f Suwanee GA 30024-6542 Ph: (678) 546-4000 |
| NPI Number | 1932351731 |
|---|---|
| Provider Enumeration Date | 10/13/2008 |
| Last Update Date | 04/03/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932351731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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