| Canton Dental | |
|
230 Riverstone Pkwy Suite A Canton GA 30114 | |
| (770) 479-5425 | |
| (770) 479-0291 |
| Full Name | Canton Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 230 Riverstone Pkwy, Canton, Georgia |
| Authorized Official Name and Position | Mark J Goch (OWNER) |
| Authorized Official Contact | 7704795425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canton Dental 230 Riverstone Pkwy Suite A Canton GA 30114 Ph: (770) 479-5425 | Canton Dental 230 Riverstone Pkwy Suite A Canton GA 30114 Ph: (770) 479-5425 |
| NPI Number | 1043386253 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043386253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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