| Children's Dentistry Of Lithonia, Llc | |
|
4850 Sugarloaf Parkway Ste 611 Lawrenceville GA 30044 | |
| (470) 299-3999 | |
| (678) 691-9589 |
| Full Name | Children's Dentistry Of Lithonia, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4850 Sugarloaf Parkway, Lawrenceville, Georgia |
| Authorized Official Name and Position | Adesegun Olushola Tewogbade (PEDIATRIC DENTIST/OWNER) |
| Authorized Official Contact | 7705845267 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dentistry Of Lithonia, Llc 4850 Sugarloaf Parkway Ste 611 Lawrenceville GA 30044 Ph: (470) 299-3999 | Children's Dentistry Of Lithonia, Llc 4850 Sugarloaf Parkway Ste 611 Lawrenceville GA 30044 Ph: (470) 299-3999 |
| NPI Number | 1316434095 |
|---|---|
| Provider Enumeration Date | 04/18/2018 |
| Last Update Date | 04/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316434095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN013400 (Georgia) | Primary |
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