| Childrens Dentistry Of Lithonia Llc | |
|
374 C North Deshon Road Stone Mountain GA 30087 | |
| (770) 469-4192 | |
| (770) 469-4195 |
| Full Name | Childrens Dentistry Of Lithonia Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 374 C North Deshon Road, Stone Mountain, Georgia |
| Authorized Official Name and Position | Adesegun Olushola Tewogbade (OWNER) |
| Authorized Official Contact | 7704694192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Dentistry Of Lithonia Llc Po Box 870272 Stone Mountain GA 30087-0007 Ph: (770) 469-4192 | Childrens Dentistry Of Lithonia Llc 374 C North Deshon Road Stone Mountain GA 30087 Ph: (770) 469-4192 |
| NPI Number | 1730348210 |
|---|---|
| Provider Enumeration Date | 06/09/2008 |
| Last Update Date | 06/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730348210 | NPI | - | NPPES |
| 1952449944 | Other | INDIVIDUAL NPI | |
| 853805701A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN013400 (Georgia) | Primary |
Sm Dentistry Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2415 W Park Place Blvd, Stone Mountain, GA 30087 Phone: 770-879-1200 Fax: 770-413-1821 | |
Metro Dekalb Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4849 Memorial Dr, Stone Mountain, GA 30083 Phone: 404-296-4119 Fax: 404-935-0905 | |
Children And Teen Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5500 Lilburn Stone Mountain Rd Ste A, Stone Mountain, GA 30087 Phone: 770-923-5500 | |
Wilkins Center For Family Dentistry Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5468 Memorial Drive Ste. A, Stone Mountain, GA 30083 Phone: 404-292-2900 Fax: 404-292-3929 | |
Stone Mountain Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4813 Rockbridge Rd Ste 26, Stone Mountain, GA 30083 Phone: 404-292-9838 Fax: 404-292-8344 | |
Drs. Gerald And Candace Rausch, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1172 Rockbridge Rd, Stone Mountain, GA 30087 Phone: 770-931-3388 Fax: 770-931-3368 | |
Ks Gasm, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5158 Memorial Dr, Stone Mountain, GA 30083 Phone: 770-916-9000 |