NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
1164956157 |   |   |   | SAGE DENTAL GROUP OF GEORGIA LLC | 4280 LAVISTA RD | TUCKER | GA | 30084 |
1518050376 | CORONADO | EFRAIN |   |   | 4280 LAVISTA RD STE C117 | TUCKER | GA | 300845315 |