Provider Demographics
NPI:1144823766
Name:DENTFIRST, P.C.
Entity type:Organization
Organization Name:DENTFIRST, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT, CRED & BENEFITS MGR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:S
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-446-8000
Mailing Address - Street 1:1650 OAKBROOK DR STE 440
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1817
Mailing Address - Country:US
Mailing Address - Phone:770-446-8000
Mailing Address - Fax:
Practice Address - Street 1:3180 N POINT PKWY STE 522
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4569
Practice Address - Country:US
Practice Address - Phone:770-755-5935
Practice Address - Fax:770-755-5945
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTFIRST, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty