Provider Demographics
NPI:1912044231
Name:DUNWOODY DENTAL GROUP
Entity Type:Organization
Organization Name:DUNWOODY DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGRIPPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-837-7448
Mailing Address - Street 1:1720 OLD SPRING HOUSE LN
Mailing Address - Street 2:SUITE 315
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6215
Mailing Address - Country:US
Mailing Address - Phone:770-451-7041
Mailing Address - Fax:
Practice Address - Street 1:1720 OLD SPRING HOUSE LN
Practice Address - Street 2:SUITE 315
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6215
Practice Address - Country:US
Practice Address - Phone:770-451-7041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty