| Alan C. Tucker, D.d.s., P.c. | |
|
639a Beaver Ruin Rd Nw Lilburn GA 30047-3401 | |
| (770) 923-5200 | |
| (770) 564-0613 |
| Full Name | Alan C. Tucker, D.d.s., P.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 639a Beaver Ruin Rd Nw, Lilburn, Georgia |
| Authorized Official Name and Position | Alan Charles Tucker (PRESIDENT) |
| Authorized Official Contact | 7709235200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alan C. Tucker, D.d.s., P.c. 639a Beaver Ruin Rd Nw Lilburn GA 30047-3401 Ph: (770) 923-5200 | Alan C. Tucker, D.d.s., P.c. 639a Beaver Ruin Rd Nw Lilburn GA 30047-3401 Ph: (770) 923-5200 |
| NPI Number | 1104904036 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104904036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 10864 (Georgia) | Primary |
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