| Vip Family Dentistry | |
|
3590 Braselton Hwy Ste 103 Dacula GA 30019-1117 | |
| (678) 318-3353 | |
| (678) 318-3350 |
| Full Name | Vip Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3590 Braselton Hwy, Dacula, Georgia |
| Authorized Official Name and Position | Patrick Van Derhei (DENTIST) |
| Authorized Official Contact | 6783183353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vip Family Dentistry 3590 Braselton Hwy Ste 103 Dacula GA 30019-1117 Ph: (678) 318-3353 | Vip Family Dentistry 3590 Braselton Hwy Ste 103 Dacula GA 30019-1117 Ph: (678) 318-3353 |
| NPI Number | 1710281795 |
|---|---|
| Provider Enumeration Date | 01/05/2011 |
| Last Update Date | 07/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710281795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN012702 (Georgia) | Secondary |
| 261QD0000X | Clinic/center - Dental | DN011854 (Georgia) | Primary |
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Yadira Cardona-rohena, Dmd Dental Clinic Medicare: Medicare Enrolled Practice Location: 4285 Jim Moore Rd, Bldg 100, Suite 104, Dacula, GA 30019 Phone: 678-835-1135 Fax: 678-835-1136 | |
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