| Gainesville Dental Center | |
|
1586 Park Hill Dr Gainesville GA 30501-1950 | |
| (770) 534-0697 | |
| (770) 534-1724 |
| Full Name | Gainesville Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 1586 Park Hill Dr, Gainesville, Georgia |
| Authorized Official Name and Position | Ketankumar G Patel (DENTIST) |
| Authorized Official Contact | 7705340697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gainesville Dental Center 1586 Park Hill Dr Gainesville GA 30501-1950 Ph: (770) 534-0697 | Gainesville Dental Center 1586 Park Hill Dr Gainesville GA 30501-1950 Ph: (770) 534-0697 |
| NPI Number | 1841319449 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 01/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841319449 | NPI | - | NPPES |
| 003142235A | Medicaid | GA | |
| 500129458D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN012835 (Georgia) | Secondary |
| 122300000X | Dentist | DN008017 (Georgia) | Secondary |
| 122300000X | Dentist | DN007359 (Georgia) | Primary |
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Sally A. Evans Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 819 Thompson Bridge Rd, Gainesville, GA 30501 Phone: 770-535-8900 Fax: 770-535-8108 |