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Mustard Seed Pediatric Dentistry, Llc
Pediatric Dentist in Suwanee, Georgia
NPI 1093048563

Mustard Seed Pediatric Dentistry, Llc is a Pediatric Dentist based in Suwanee, GA and is specialized in Pediatric Dentistry. Mustard Seed Pediatric Dentistry, Llc practices in Suwanee, GA. The NPI Number for Mustard Seed Pediatric Dentistry, Llc is 1093048563 and holds a License No. DN013415 (Georgia).

The current practice location address for Mustard Seed Pediatric Dentistry, Llc is 1120 Peachtree Industrial Blvd, Suwanee, GA and can be reached out via phone at 770-904-7005 and via fax at 770-904-7075.

Location: 1120 Peachtree Industrial Blvd, Suwanee, GA, 30024-2013
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1093048563
Provider Name
Mustard Seed Pediatric Dentistry, Llc
Credential
Provider Entity Type
Organization
Address
1120 Peachtree Industrial Blvd, Suwanee, GA, 30024-2013
Phone Number
770-904-7005
Fax Number
770-904-7075
Provider Enumeration Date
09/15/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1255479689 01 GA INDIVIDUAL NPI #
institution
Provider Business Practice Location Address Details
Address
1120 Peachtree Industrial Blvd
City
Suwanee
State
Georgia
Zip
30024-2013
Phone Number
770-904-7005
Fax Number
770-904-7075
person
Provider Business Mailing Address Details
Address
1120 Peachtree Industrial Blvd
City
Suwanee
State
Georgia
Zip
30024-2013
Phone Number
770-904-7005
Fax Number
770-904-7075
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DN013415 (Georgia)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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