Provider Demographics
NPI:1346344504
Name:JEFFREY G PRILUCK DMD PC AND ALBERT P NORDONE DDS
Entity Type:Organization
Organization Name:JEFFREY G PRILUCK DMD PC AND ALBERT P NORDONE DDS
Other - Org Name:PRILUCK AND NORDONE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:G
Authorized Official - Last Name:PRILUCK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-393-9450
Mailing Address - Street 1:5548 CHAMBLEE DUNWOODY ROAD
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338
Mailing Address - Country:US
Mailing Address - Phone:770-393-9450
Mailing Address - Fax:770-392-0647
Practice Address - Street 1:5548 CHAMBLEE DUNWOODY ROAD
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338
Practice Address - Country:US
Practice Address - Phone:770-393-9450
Practice Address - Fax:770-392-0647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental