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General NPI Number Information
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NPI Number | 1689731457
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL ASSOCIATES LLC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 285 ELM STREET SUITE 200
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City | CUMMING
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State | GA
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Zip | 30040
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Country | US
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Telephone | 770-887-2915
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Fax | 770-887-0575
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Provider Business Mailing Address
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Address Line | 285 ELM STREET SUITE 200
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City | CUMMING
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State | GA
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Zip | 30040
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Country | US
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Telephone | 770-887-2915
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Fax | 770-887-0575
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Authorized Official
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Title or Position | MANAGER TREASURE
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Name | DR. ROBERT M JOINER
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Credential | DDS
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Telephone | 770-887-2915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9257
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License Number State | GA
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