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NPI 1851729883

OrganizationActive

Avala Dental Providers,llc

NPI 1851729883 · Point of Service · Lilburn, GA

Provider details

NPI number: 1851729883
Entity type: Organization
Primary specialty: Point of ServiceManaged Care Organizations
Authorized official: Tiffany Jamison, Owner
License: DN014034 (GA)

Practice location

629 a Beaver Ruin Rd

Lilburn, GA 30047

Phone: (770) 696-4144

Fax: (470) 545-2859

More GA providers

Mailing address

629 a Beaver Ruin Rd

Lilburn, GA 30047

Registry dates

Enumerated: 2013-10-30
Last updated: 2013-10-30

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Avala Dental Providers,llc — NPI 1851729883, Lilburn, GA | NPI Central