Provider Demographics
NPI:1558541763
Name:OAK ROAD DENTISTRY
Entity Type:Organization
Organization Name:OAK ROAD DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:N
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-985-9559
Mailing Address - Street 1:2176 OAK RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2374
Mailing Address - Country:US
Mailing Address - Phone:770-985-9559
Mailing Address - Fax:
Practice Address - Street 1:2176 OAK RD
Practice Address - Street 2:SUITE A
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2374
Practice Address - Country:US
Practice Address - Phone:770-985-9559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADNO12572122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty