Provider Demographics
NPI:1952424665
Name:ROBERT D. WOODS DDS, PC
Entity Type:Organization
Organization Name:ROBERT D. WOODS DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DEWAYNE
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-551-0808
Mailing Address - Street 1:4190 OLD MILTON PKWY
Mailing Address - Street 2:STE 2-G
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-6459
Mailing Address - Country:US
Mailing Address - Phone:770-551-0808
Mailing Address - Fax:
Practice Address - Street 1:4190 OLD MILTON PKWY
Practice Address - Street 2:STE 2-G
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-6459
Practice Address - Country:US
Practice Address - Phone:770-551-0808
Practice Address - Fax:770-395-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN010466261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental