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Blossom Pediatric Dentistry, Llc
Pediatric Dentist in Suwanee, Georgia
NPI 1164145827

Blossom Pediatric Dentistry, Llc is a Pediatric Dentist based in Suwanee, GA and is specialized in Pediatric Dentistry. Blossom Pediatric Dentistry, Llc practices in Suwanee, GA. The NPI Number for Blossom Pediatric Dentistry, Llc is 1164145827 and holds a License No. (Georgia).

The current practice location address for Blossom Pediatric Dentistry, Llc is 345 Peachtree Industrial Blvd Ste 1102-1103, Suwanee, GA and can be reached out via phone at 770-609-5603.

Location: 345 Peachtree Industrial Blvd Ste 1102-1103, Suwanee, GA, 30024-8823
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164145827
Provider Name
Blossom Pediatric Dentistry, Llc
Credential
Provider Entity Type
Organization
Address
345 Peachtree Industrial Blvd Ste 1102-1103, Suwanee, GA, 30024-8823
Phone Number
770-609-5603
Fax Number
Provider Enumeration Date
09/19/2022
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1811302474 01 GA INDIVIDUAL NPI
institution
Provider Business Practice Location Address Details
Address
345 Peachtree Industrial Blvd Ste 1102-1103
City
Suwanee
State
Georgia
Zip
30024-8819
Phone Number
770-609-5603
Fax Number
person
Provider Business Mailing Address Details
Address
345 Peachtree Industrial Blvd Ste 1102-1103
City
Suwanee
State
Georgia
Zip
30024-8819
Phone Number
770-609-5603
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
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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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