Provider Demographics
NPI:1619640083
Name:GEORGIA DENTAL STUDIO LLC
Entity type:Organization
Organization Name:GEORGIA DENTAL STUDIO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERGOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-347-8415
Mailing Address - Street 1:PO BOX 260
Mailing Address - Street 2:
Mailing Address - City:JERSEY
Mailing Address - State:GA
Mailing Address - Zip Code:30018-0260
Mailing Address - Country:US
Mailing Address - Phone:770-464-3626
Mailing Address - Fax:770-464-2303
Practice Address - Street 1:150 MAIN STREET
Practice Address - Street 2:
Practice Address - City:JERSEY
Practice Address - State:GA
Practice Address - Zip Code:30018
Practice Address - Country:US
Practice Address - Phone:770-464-3626
Practice Address - Fax:770-464-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental