NPI | 1316434095 |
---|---|
Doing Business As | CHILDREN'S DENTISTRY OF LAWRENCEVILLE |
Entity Type | Organization |
Authorized Contact | ADESEGUN OLUSHOLA TEWOGBADE Pediatric Dentist/Owner 770-584-5267 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013400) |
Enumeration Date | 2018-04-18 |
Last Update Date | 2018-04-18 |