Organization · Type 2 NPI
Paul Ivey Nettles LLC
Pediatric Dentistry · College Park, GA
NPI number
1063564078
Active
Practice location
1177 Garden Walk Blvd
College Park, GA 30349-6245
Mailing address
730 Highmeade Ter
Alpharetta, GA 30005-3755
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry | 1223G0001X | 11589 (GA) |
| Pediatric Dentistry Primary | 1223P0221X | 6742 (GA) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
5 other providers at this address
- Dharmesh Parbhoo P.c.Dental Clinic/Center College Park, GA NPI 1912188848
- Vivid Smile Dental CenterGeneral Practice Dentistry College Park, GA NPI 1720383805
- Alan B. GoldmanPediatric Dentistry College Park, GA NPI 1326169012
- Alex Christopher Harvey, DMDDentist College Park, GA NPI 1023446010
- Edmond Michael Franklin, DDSDentist College Park, GA NPI 1497999841
About NPI 1063564078
Paul Ivey Nettles LLC's National Provider Identifier is 1063564078, issued on Jan 18, 2007. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in College Park, GA. The record was last updated on Sep 11, 2025.