Provider Demographics
NPI:1942420856
Name:PARKWAY DENTAL
Entity Type:Organization
Organization Name:PARKWAY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:P
Authorized Official - Last Name:VAKHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-979-0661
Mailing Address - Street 1:1977 SCENIC HWY N STE D
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2137
Mailing Address - Country:US
Mailing Address - Phone:770-979-0661
Mailing Address - Fax:770-982-0482
Practice Address - Street 1:1977 SCENIC HWY N STE D
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2137
Practice Address - Country:US
Practice Address - Phone:770-979-0661
Practice Address - Fax:770-982-0482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0132181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty