Provider Demographics
NPI:1023183035
Name:ACE ORTHODONTICS AND DENTISTRY,LLC
Entity Type:Organization
Organization Name:ACE ORTHODONTICS AND DENTISTRY,LLC
Other - Org Name:PAUL W. LINDO DDS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:WASHINGTON
Authorized Official - Last Name:LINDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-892-2110
Mailing Address - Street 1:1922 HIGHWAY 74 N
Mailing Address - Street 2:STE. E
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-1660
Mailing Address - Country:US
Mailing Address - Phone:770-892-2110
Mailing Address - Fax:770-892-2126
Practice Address - Street 1:1922 HIGHWAY 74 N
Practice Address - Street 2:STE. E
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-1660
Practice Address - Country:US
Practice Address - Phone:770-892-2110
Practice Address - Fax:770-892-2126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011348122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty