| Gangwisch Dental Group, L.l.c. | |
|
912 Killian Hill Rd Sw Suite 100 Lilburn GA 30047-3138 | |
| (770) 923-3966 | |
| Not Available |
| Full Name | Gangwisch Dental Group, L.l.c. |
|---|---|
| Speciality | Dentist |
| Location | 912 Killian Hill Rd Sw, Lilburn, Georgia |
| Authorized Official Name and Position | Richard Gangwisch (MEMBER) |
| Authorized Official Contact | 7709233966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gangwisch Dental Group, L.l.c. 912 Killian Hill Rd Sw Suite 100 Lilburn GA 30047-3138 Ph: (770) 923-3966 | Gangwisch Dental Group, L.l.c. 912 Killian Hill Rd Sw Suite 100 Lilburn GA 30047-3138 Ph: (770) 923-3966 |
| NPI Number | 1588849186 |
|---|---|
| Provider Enumeration Date | 01/02/2008 |
| Last Update Date | 01/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588849186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN008859 (Georgia) | Primary |
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