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860 Duluth Hwy Ste 1030 Lawrenceville GA 30043-5349 | |
| (770) 401-4719 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 860 Duluth Hwy Ste 1030, Lawrenceville, Georgia |
| Authorized Official Name and Position | To Nga Thi Dinh (OWNER) |
| Authorized Official Contact | 7704014719 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4530 Fairway View Ct Duluth GA 30096-6091 Ph: (770) 401-4719 | 860 Duluth Hwy Ste 1030 Lawrenceville GA 30043-5349 Ph: (770) 401-4719 |
| NPI Number | 1760831101 |
|---|---|
| Provider Enumeration Date | 06/07/2016 |
| Last Update Date | 06/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760831101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN014611 (Georgia) | Primary |
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