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General NPI Number Information
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NPI Number | 1962707711
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Entity Type | Organization
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Legal Business Name | DAWSON DENTAL GROUP, LLC
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 6625 HIGHWAY 53 E SUITE 440
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City | DAWSONVILLE
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State | GA
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Zip | 30534-6838
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Country | US
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Telephone | 706-265-0005
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Fax |
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Provider Business Mailing Address
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Address Line | 6625 HIGHWAY 53 E SUITE 440
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City | DAWSONVILLE
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State | GA
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Zip | 30534-6838
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Country | US
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Telephone | 706-265-0005
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RITU SETHI NAGAR
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Credential | DMD
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Telephone | 412-848-9007
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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 | DN013590
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License Number State | GA
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