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General NPI Number Information
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NPI Number | 1255241519
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Entity Type | Organization
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Legal Business Name | DENTAL EMERGENCY CENTER - LAWRENCEVILLE, LLC
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/09/2026
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Provider Practice Location Address
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Address Line | 1475 BUFORD DR STE 204
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-3798
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Country | US
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Telephone | 404-689-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 3334 EMDEN CT
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City | SNELLVILLE
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State | GA
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Zip | 30039-6047
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Country | US
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Telephone | 404-689-3334
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Fax |
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Authorized Official
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Title or Position | OPERATOR
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Name | DR. ERIC ENNUSON
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Credential | DDS
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Telephone | 404-689-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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