Provider Demographics
NPI:1467928549
Name:SUN FAMILY DENTAL LLC
Entity Type:Organization
Organization Name:SUN FAMILY DENTAL LLC
Other - Org Name:SUN FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAINAL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:678-890-2555
Mailing Address - Street 1:5620 COMMERCE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4183
Mailing Address - Country:US
Mailing Address - Phone:678-890-2555
Mailing Address - Fax:678-999-4861
Practice Address - Street 1:5620 COMMERCE BLVD STE B
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-4183
Practice Address - Country:US
Practice Address - Phone:678-890-2555
Practice Address - Fax:678-999-4861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental