| Woodstock Dentist Llc | |
|
8294 Highway 92 Ste 200 Woodstock GA 30189-3672 | |
| (678) 483-5999 | |
| Not Available |
| Full Name | Woodstock Dentist Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8294 Highway 92 Ste 200, Woodstock, Georgia |
| Authorized Official Name and Position | Praveen R Gudipati (OWNER) |
| Authorized Official Contact | 4049667766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodstock Dentist Llc 2705 Azalea Bluff Dr Cumming GA 30041-3207 Ph: (404) 966-7766 | Woodstock Dentist Llc 8294 Highway 92 Ste 200 Woodstock GA 30189-3672 Ph: (678) 483-5999 |
| NPI Number | 1316701493 |
|---|---|
| Provider Enumeration Date | 02/09/2024 |
| Last Update Date | 03/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316701493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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