Provider Demographics
NPI:1760920706
Name:BDD,LLC
Entity Type:Organization
Organization Name:BDD,LLC
Other - Org Name:SUGAR HILL DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:POPWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-945-2119
Mailing Address - Street 1:4520 NELSON BROGDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-3478
Mailing Address - Country:US
Mailing Address - Phone:770-945-2119
Mailing Address - Fax:
Practice Address - Street 1:4520 NELSON BROGDON BLVD
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3478
Practice Address - Country:US
Practice Address - Phone:770-945-2119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0120131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty