| Dixie Street Dental Llc | |
|
409 Dixie St Carrollton GA 30117-3921 | |
| (770) 834-9682 | |
| Not Available |
| Full Name | Dixie Street Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 409 Dixie St, Carrollton, Georgia |
| Authorized Official Name and Position | Troy Hunter Chastain (DENTIST) |
| Authorized Official Contact | 4049095314 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dixie Street Dental Llc 409 Dixie St Carrollton GA 30117-3921 Ph: (770) 834-9682 | Dixie Street Dental Llc 409 Dixie St Carrollton GA 30117-3921 Ph: (770) 834-9682 |
| NPI Number | 1659173334 |
|---|---|
| Provider Enumeration Date | 03/25/2025 |
| Last Update Date | 03/25/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659173334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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