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Avala Dental Providers,llc
Point of Service in Lilburn, Georgia
NPI 1851729883

Avala Dental Providers,llc is a Point of Service based in Lilburn, GA. Avala Dental Providers,llc practices in Lilburn, GA. The NPI Number for Avala Dental Providers,llc is 1851729883 and holds a License No. DN014034 (Georgia).

The current practice location address for Avala Dental Providers,llc is 629 A Beaver Ruin Rd, Lilburn, GA and can be reached out via phone at 770-696-4144 and via fax at 470-545-2859.

Location: 629 A Beaver Ruin Rd, Lilburn, GA, 30047
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1851729883
Provider Name
Avala Dental Providers,llc
Credential
Provider Entity Type
Organization
Address
629 A Beaver Ruin Rd, Lilburn, GA, 30047
Phone Number
770-696-4144
Fax Number
470-545-2859
Provider Enumeration Date
10/30/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1487953741 05 GA
institution
Provider Business Practice Location Address Details
Address
629 A Beaver Ruin Rd
City
Lilburn
State
Georgia
Zip
30047
Phone Number
770-696-4144
Fax Number
470-545-2859
person
Provider Business Mailing Address Details
Address
629 A Beaver Ruin Rd
City
Lilburn
State
Georgia
Zip
30047
Phone Number
770-696-4144
Fax Number
470-545-2859
person
Provider's Taxonomy Details 1
Type
Managed Care Organizations
Classification
Point of Service
Speciality
-
Taxonomy
305S00000X
License No.
DN014034 (Georgia)
Definition
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
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