Provider Demographics
NPI:1518602937
Name:GUARD 9 LLC
Entity Type:Organization
Organization Name:GUARD 9 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TO NGA
Authorized Official - Middle Name:THI
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-401-4719
Mailing Address - Street 1:860 DULUTH HWY STE 1030
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5349
Mailing Address - Country:US
Mailing Address - Phone:770-682-7380
Mailing Address - Fax:
Practice Address - Street 1:860 DULUTH HWY STE 1030
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5349
Practice Address - Country:US
Practice Address - Phone:770-682-7380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty