| Vineyards Dental Care | |
|
2095 Highway 211 Nw Suite 6-a Braselton GA 30517-3402 | |
| (770) 868-4288 | |
| (770) 868-4291 |
| Full Name | Vineyards Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2095 Highway 211 Nw, Braselton, Georgia |
| Authorized Official Name and Position | Thomas J. Mazzuckelli (OWNER) |
| Authorized Official Contact | 7708684288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vineyards Dental Care 2095 Highway 211 Nw Suite 6-a Braselton GA 30517-3402 Ph: (770) 868-4288 | Vineyards Dental Care 2095 Highway 211 Nw Suite 6-a Braselton GA 30517-3402 Ph: (770) 868-4288 |
| NPI Number | 1225191935 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225191935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DNO 14417 (Georgia) | Primary |
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