| Origin Dental Llc | |
|
5635 Peachtree Pkwy Ste 200 Peachtree Corners GA 30092-2823 | |
| (678) 990-1001 | |
| Not Available |
| Full Name | Origin Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5635 Peachtree Pkwy Ste 200, Peachtree Corners, Georgia |
| Authorized Official Name and Position | Sean Lan (OWNER/PRINCIPAL DENTIST) |
| Authorized Official Contact | 7726781863 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Origin Dental Llc 5635 Peachtree Pkwy Ste 200 Peachtree Corners GA 30092-2823 Ph: (678) 990-1001 | Origin Dental Llc 5635 Peachtree Pkwy Ste 200 Peachtree Corners GA 30092-2823 Ph: (678) 990-1001 |
| NPI Number | 1275489957 |
|---|---|
| Provider Enumeration Date | 03/06/2026 |
| Last Update Date | 03/06/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275489957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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