Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fayetteville Pediatric Dentistry

Organization Pediatric Dentistry · NPI 1073056933

Fayetteville Pediatric Dentistry provides Pediatric Dentistry in Fayetteville, Georgia. Licensed in Georgia. Registered with an NPI since 2016.

Licensed in
GA
In the registry since
2016

Practice location Address checks out

320 N Jeff Davis Dr Ste C
Fayetteville, GA 30214-1669
Phone: (770) 651-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence DN013057 (GA)

Record details

NPI number1073056933
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Vishant Nath — Dentist · (770) 651-1000
NPI enumeratedNovember 28, 2016
Last updated in NPPESNovember 28, 2016
Mailing address320 N Jeff Davis Dr, Suite C, Fayetteville, GA 30214-1669

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