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General NPI Number Information
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NPI Number | 1902761968
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Entity Type | Organization
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Legal Business Name | PREMIER ENDODONTICS, LLC
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 4895 WINDWARD PKWY STE 202
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City | ALPHARETTA
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State | GA
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Zip | 30004-3850
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Country | US
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Telephone | 770-291-0700
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Fax | 770-470-6594
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Provider Business Mailing Address
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Address Line | 4895 WINDWARD PKWY STE 202
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City | ALPHARETTA
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State | GA
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Zip | 30004-3850
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Country | US
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Telephone | 770-291-0700
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Fax | 770-470-6594
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Authorized Official
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Title or Position | ENDODONTIST
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Name | DR. LARA BACHOUR
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Credential | DMD, MDS
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Telephone | 614-440-7317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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