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General NPI Number Information
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NPI Number | 1073851572
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Entity Type | Organization
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Legal Business Name | MINNITI DENTISTRY, PC
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Dates
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Enumeration Date | 01/18/2013
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Last Update Date | 01/18/2013
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Provider Practice Location Address
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Address Line | 270 SAINT CLAIRE DR SUITES 104-105
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City | ALPHARETTA
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State | GA
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Zip | 30004-5728
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Country | US
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Telephone | 678-990-8590
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Fax | 678-990-8594
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Provider Business Mailing Address
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Address Line | 270 SAINT CLAIRE DR SUITES 104-105
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City | ALPHARETTA
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State | GA
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Zip | 30004-5728
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Country | US
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Telephone | 678-990-8590
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Fax | 678-990-8594
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LORENZO MINNITI
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Credential | D.D.S.
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Telephone | 678-990-8590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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