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ROYAL LAKES FAMILY AND COSMETIC DENTISTRY LLC NPI 1710216783


NPI Information

NPI: 1710216783
Provider Name: ROYAL LAKES FAMILY AND COSMETIC DENTISTRY, LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
4005 WINDER HWY
SUITE 100
FLOWERY BRANCH, GA
ZIP 30542
Phone: (770) 531-3232
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ROYAL LAKES FAMILY AND COSMETIC DENTISTRY, LLC is a general practice dentist in Flowery Branch, GA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. ROYAL LAKES FAMILY AND COSMETIC DENTISTRY, LLC NPI is 1710216783. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4005 WINDER HWY
SUITE 100
FLOWERY BRANCH, GA
ZIP 30542-564
Phone: (770) 531-3232
Fax: (770) 531-3238

The provider's authorized official is Reginald Douglas Booker .
The authorized official title is Owner/dentist and has the following contact phone number (770) 531-3232.

The enumeration date for this NPI number is 12/21/2009 and was last updated on 12/21/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeDN013464GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11699711416OTHERGEORGIAINDIVIDUAL NPI NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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