OrganizationActive
Alan C. Tucker, D.D.S., P.C.
NPI 1104904036 · Oral and Maxillofacial Surgery (Dentist) · Lilburn, GA
Provider details
- NPI number
- 1104904036
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Authorized official
- Alan Tucker, President
- License
- 10864 (GA)
Practice location
639a Beaver Ruin Rd Nw
Lilburn, GA 30047-3401
Phone: (770) 923-5200
Fax: (770) 564-0613
Mailing address
639a Beaver Ruin Rd Nw
Lilburn, GA 30047-3401
Registry dates
- Enumerated
- 2006-11-01
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.