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9020 Highway 92 Suite 120 Woodstock GA 30189-3753 | |
(770) 928-4511 | |
(770) 928-4310 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 9020 Highway 92, Woodstock, Georgia |
Authorized Official Name and Position | Anita L Falvai (PRACTICE ADMIN) |
Authorized Official Contact | 7709284511 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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9020 Highway 92 Suite 120 Woodstock GA 30189-3753 Ph: (770) 928-4511 | 9020 Highway 92 Suite 120 Woodstock GA 30189-3753 Ph: (770) 928-4511 |
NPI Number | 1770754426 |
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Provider Enumeration Date | 03/20/2008 |
Last Update Date | 04/02/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770754426 | NPI | - | NPPES |
211792479N | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | DN012608 (Georgia) | Primary |
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