Provider Demographics
NPI:1790954550
Name:DENTAL OFFICES OF SAMUEL E. TOURIAL, D.D.S., P.C.
Entity Type:Organization
Organization Name:DENTAL OFFICES OF SAMUEL E. TOURIAL, D.D.S., P.C.
Other - Org Name:SAMUEL E. TOURIAL, D.D.S., P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:TOURIAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-277-3880
Mailing Address - Street 1:603 OLD NORCROSS RD STE B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-4315
Mailing Address - Country:US
Mailing Address - Phone:770-277-3880
Mailing Address - Fax:770-277-5991
Practice Address - Street 1:603 OLD NORCROSS RD STE B
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-4315
Practice Address - Country:US
Practice Address - Phone:770-277-3880
Practice Address - Fax:770-277-5991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0101831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty