Blossom Pediatric Dentistry, Llc | |
345 Peachtree Industrial Blvd Ste 1102-1103 Suwanee GA 30024-8819 | |
(770) 609-5603 | |
Not Available |
Full Name | Blossom Pediatric Dentistry, Llc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 345 Peachtree Industrial Blvd Ste 1102-1103, Suwanee, Georgia |
Authorized Official Name and Position | Whitney Lyons (OWNER/DENTIST) |
Authorized Official Contact | 7706095603 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Blossom Pediatric Dentistry, Llc 345 Peachtree Industrial Blvd Ste 1102 Suwanee GA 30024-8823 Ph: (770) 609-4722 | Blossom Pediatric Dentistry, Llc 345 Peachtree Industrial Blvd Ste 1102-1103 Suwanee GA 30024-8819 Ph: (770) 609-5603 |
NPI Number | 1164145827 |
---|---|
Provider Enumeration Date | 09/19/2022 |
Last Update Date | 08/03/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164145827 | NPI | - | NPPES |
1811302474 | Other | GA | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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