| Atlanta Emergency Dental Center | |
|
4060 Lavista Rd Tucker GA 30084-5216 | |
| (770) 934-0770 | |
| (770) 934-3063 |
| Full Name | Atlanta Emergency Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4060 Lavista Rd, Tucker, Georgia |
| Authorized Official Name and Position | Leon Grayland Pye (PRESIDENT) |
| Authorized Official Contact | 7709340770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlanta Emergency Dental Center 4060 Lavista Rd Tucker GA 30084-5216 Ph: (770) 934-0770 | Atlanta Emergency Dental Center 4060 Lavista Rd Tucker GA 30084-5216 Ph: (770) 934-0770 |
| NPI Number | 1447480652 |
|---|---|
| Provider Enumeration Date | 07/22/2009 |
| Last Update Date | 07/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447480652 | NPI | - | NPPES |
| 00172235F | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8962 (Georgia) | Primary |
Orthodontic Care Of Georgia Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3983 Lavista Rd, Suite 192 Thru 196, Tucker, GA 30084 Phone: 770-939-3700 Fax: 770-685-7668 | |
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