Healthcare Provider Details
I. General information
NPI: 1972442747
Provider Name (Legal Business Name): CHILDREN'S DENTISTRY OF LITHONIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7215 STONECREST PKWY
LITHONIA GA
30038-2563
US
IV. Provider business mailing address
7215 STONECREST PKWY
LITHONIA GA
30038-2563
US
V. Phone/Fax
- Phone: 770-482-4661
- Fax: 770-264-5229
- Phone: 770-482-4661
- Fax: 770-264-5229
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TODD
L
ASARCH
Title or Position: OWNER
Credential: DDS
Phone: 770-482-4661