Provider Demographics
NPI:1902933161
Name:SKOGLUND, DAVID A (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:SKOGLUND
Suffix:
Gender:M
Credentials:DMD
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Mailing Address - Street 1:3300 MILL VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-1298
Mailing Address - Country:US
Mailing Address - Phone:770-945-5080
Mailing Address - Fax:678-714-8388
Practice Address - Street 1:2119 HAMILTON CREEK PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-3293
Practice Address - Country:US
Practice Address - Phone:770-614-7011
Practice Address - Fax:678-714-8388
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADN0128731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry