Blossom Pediatric Dentistry, Llc

LBN: Blossom Pediatric Dentistry, Llc
Blossom Pediatric Dentistry, Llc is an health care organization with primary practice located at 345 Peachtree Industrial Blvd Ste 1102-1103 , Suwanee GA 30024-8819. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Blossom Pediatric Dentistry, Llc can be contacted via phone (770) 609-5603, or through Lyons, Whitney via phone (770) 609-5603.

Contact Information

Primary practice address
345 Peachtree Industrial Blvd Ste 1102-1103 Suwanee GA 30024-8819
Phone: (770) 609-5603
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lyons, Whitney Doctor of Dental Medicine (DMD)
Phone: (770) 609-5603

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1164145827
LBN Legal business name Blossom Pediatric Dentistry, Llc
DBA Doing business as
Authorized official Lyons, Whitney Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 19th, 2022
Last updated Aug 3rd, 2023 - about 2 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 1164145827 NPPES
Georgia Other 1811302474 INDIVIDUAL NPI

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