Polish Dental Center,Llc

LBN: Avala Dental Providers,Llc
Polish Dental Center,Llc is an health care organization with primary practice located at 629 A Beaver Ruin Rd , Lilburn GA 30047. The organization recently has only one registered license in Managed Care Organizations / Point of Service, which is considered as the primary health care specialty. Avala Dental Providers,Llc can be contacted via phone (770) 696-4144, or through Jamison, Tiffany N via phone (770) 696-4144.

Contact Information

Primary practice address
629 A Beaver Ruin Rd Lilburn GA 30047
Phone: (770) 696-4144
Fax: (470) 545-2859
Website:
Map and Directions
Authorized official contact:
Name: Jamison, Tiffany N Doctor of Dental Medicine (DMD)
Phone: (770) 696-4144

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Point of Service 305S00000X DN014034 Georgia

Profile Details

NPI number 1851729883
LBN Legal business name Avala Dental Providers,Llc
DBA Doing business as Polish Dental Center,Llc
Authorized official Jamison, Tiffany N Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 30th, 2013
Last updated Oct 30th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851729883 NPPES
Georgia MEDICAID 1487953741

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