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General NPI Number Information
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NPI Number | 1912059866
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Entity Type | Organization
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Legal Business Name | AT DENTAL, P.C
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1154 LAWRENCEVILLE HWY STE. 102
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-2434
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Country | US
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Telephone | 770-277-0774
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Fax | 770-277-0520
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Provider Business Mailing Address
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Address Line | 1154 LAWRENCEVILLE HWY STE. 102
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-2434
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Country | US
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Telephone | 770-277-0774
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Fax | 770-277-0520
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TU ANH NGUYEN
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Credential | DDS
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Telephone | 770-277-0774
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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 |
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License Number State |
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