| Cosmetic And Family Dentistry Of Marietta | |
|
1611 Sands Pl Se Ste 100 Marietta GA 30067-8704 | |
| (770) 226-0008 | |
| (770) 226-0700 |
| Full Name | Cosmetic And Family Dentistry Of Marietta |
|---|---|
| Speciality | Dentist |
| Location | 1611 Sands Pl Se Ste 100, Marietta, Georgia |
| Authorized Official Name and Position | Kenneth Morris Wiggins (DR./DENTIST) |
| Authorized Official Contact | 7702260008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cosmetic And Family Dentistry Of Marietta Po Box 7718 Marietta GA 30065-1718 Ph: (770) 226-0008 | Cosmetic And Family Dentistry Of Marietta 1611 Sands Pl Se Ste 100 Marietta GA 30067-8704 Ph: (770) 226-0008 |
| NPI Number | 1023264322 |
|---|---|
| Provider Enumeration Date | 08/18/2008 |
| Last Update Date | 08/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023264322 | NPI | - | NPPES |
| 829858019A | Medicaid | GA | |
| 829858019B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN012484 (Georgia) | Secondary |
| 122300000X | Dentist | DN012485 (Georgia) | Primary |
Damian Sommerville, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1951 Canton Rd, Ste 310, Marietta, GA 30066 Phone: 770-423-0324 | |
Kimchang & Company, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2155 Post Oak Tritt Rd Ste 450, Marietta, GA 30062 Phone: 770-971-5536 Fax: 770-971-3046 | |
East Cobb Nia Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1111 Johnson Ferry Rd, Marietta, GA 30068 Phone: 770-479-9999 | |
L R Smiles Of Marietta, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3698 Largent Way Suite 202, Marietta, GA 30064 Phone: 770-423-4900 | |
Sprayberry Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2663 Sandy Plains Rd, Marietta, GA 30066 Phone: 770-977-0827 Fax: 770-973-6764 | |
Enoch And Lamei Orthodontics, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2155 Post Oak Tritt Rd Ste 180, Marietta, GA 30062 Phone: 770-977-0377 |