Organization · Type 2 NPI
Lakeside Pediatric Dentistry, LLC
Pediatric Dentistry · Greensboro, GA
NPI number
1174064539
Active
Practice location
1050 Parkside Cmns, Suite 103
Greensboro, GA 30642-4524
Fax (706) 454-1234
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | DN012737 (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.
About NPI 1174064539
Lakeside Pediatric Dentistry, LLC's National Provider Identifier is 1174064539, issued on Mar 17, 2017. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Greensboro, GA. The record was last updated on Mar 17, 2017.