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PROFESSIONAL DENTAL ALLIANCE OF GEORGIA LLC NPI 1861900946


NPI Information

NPI: 1861900946
Provider Name: PROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
3466 COBB PKWY NW STE 170
ACWORTH, GA
ZIP 30101
Phone: (770) 203-1711
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PROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC is a general practice dentist in Acworth, 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. PROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC NPI is 1861900946. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3466 COBB PKWY NW STE 170
ACWORTH, GA
ZIP 30101-768
Phone: (770) 203-1711
Fax: (404) 855-4104

The provider's authorized official is Andrew Matta .
The authorized official title is Owner and has the following contact phone number (724) 698-2500.

The enumeration date for this NPI number is 1/11/2018 and was last updated on 3/17/2018.


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 PracticeDN013474GEORGIAYes

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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