| Wayne T. Tadsen Dmd Pc | |
|
102 Gordon St Lawrenceville GA 30045-6910 | |
| (770) 995-6215 | |
| (770) 995-6263 |
| Full Name | Wayne T. Tadsen Dmd Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 102 Gordon St, Lawrenceville, Georgia |
| Authorized Official Name and Position | Wayne Theodore Tadsen (PRESIDENT, OWNER) |
| Authorized Official Contact | 7709956215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne T. Tadsen Dmd Pc 102 Gordon St Lawrenceville GA 30045-6910 Ph: (770) 995-6215 | Wayne T. Tadsen Dmd Pc 102 Gordon St Lawrenceville GA 30045-6910 Ph: (770) 995-6215 |
| NPI Number | 1407979099 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407979099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN008626 (Georgia) | Primary |
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