| Georgia Dental Group-lagrange PC | |
|
313 Mooty Bridge Rd Lagrange GA 30240-1809 | |
| (706) 365-0016 | |
| Not Available |
| Full Name | Georgia Dental Group-lagrange PC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 313 Mooty Bridge Rd, Lagrange, Georgia |
| Authorized Official Name and Position | Christopher Zacharewicz (COO) |
| Authorized Official Contact | 9139611270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Dental Group-lagrange PC 134 Professional Way Baldwin GA 30511-4000 Ph: (913) 961-1270 | Georgia Dental Group-lagrange PC 313 Mooty Bridge Rd Lagrange GA 30240-1809 Ph: (706) 365-0016 |
| NPI Number | 1720999808 |
|---|---|
| Provider Enumeration Date | 09/16/2026 |
| Last Update Date | 09/16/2026 |
| Certification Date | 09/15/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720999808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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