PROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC
NPI 1861900946
Dentist - General Practice in Acworth, GA

Active since January 11, 2018
3466 COBB PKWY NW STE 170, ACWORTH, GA 30101(770) 203-1711(404) 855-4104 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 17, 2018, Feb 23, 2018, Jan 11, 2018 (3 updates tracked since 2018).

About Professional Dental Alliance Of Georgia, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC (NPI 1861900946) is a healthcare organization registered as a general practice in Acworth, Georgia and active in the NPI registry since January 2018. The organization maintains 7 additional practice locations and lists Andrew Matta, Owner, as its authorized official.

NPPES Registry Identity

NPI1861900946
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC
Location Address3466 COBB PKWY NW STE 170Acworth, GA 30101-5768
Mailing Address11 S Mill StNew Castle, PA 16101-3680
Fax(404) 855-4104
Organization SubpartNo
Authorized OfficialAndrew MattaOwner · (724) 698-2500
Enumeration DateJanuary 11, 2018
Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration
NPI 1861900946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in GA · DN013474
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

3466 COBB PKWY NW STE 170, Acworth, GA 30101

Secondary Practice Locations 7

Location 11867 Jonesboro Rd Ste 6McDonough, GA 30253-6099 · Phone (678) 432-0209 · Fax (404) 855-4104
Location 24353 Atlanta Hwy Ste 300Loganville, GA 30052-3232 · Phone (770) 450-2030 · Fax (404) 855-4104
Location 3740 Ferst Dr NW Suite 207Atlanta, GA 30322-0001 · Phone (404) 733-2022 · Fax (404) 855-4104
Location 45304 Windward Pkwy Ste 107Alpharetta, GA 30004-3828 · Phone (770) 777-1911 · Fax (404) 855-4104
Location 54374 Atlanta Hwy Ste 109Hiram, GA 30141-1849 · Phone (770) 505-9898 · Fax (404) 855-4104
Location 610373 Industrial Blvd NECovington, GA 30014-1403 · Phone (678) 306-6000 · Fax (404) 855-4104
Location 73230 Lawrenceville Suwanee Rd, 300Suwanee, GA 30024 · Phone (724) 698-2500

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Oral and Maxillofacial Pathology)
3466 COBB PKWY NW STE 170
ACWORTH, GA 30101
Dentist (General Practice)
3466 COBB PKWY NW STE 170
ACWORTH, GA 30101

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1861900946, enumerated as an "organization" on January 11, 2018.

The provider is located at 3466 COBB PKWY NW STE 170 ACWORTH, GA 30101 and the phone number is (770) 203-1711.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to verify.