| J Michael Dierkes Family Orthodontics Llc | |
|
910 Marietta Hwy Suite Roswell GA 30075-6771 | |
| (678) 352-0919 | |
| (678) 352-8330 |
| Full Name | J Michael Dierkes Family Orthodontics Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 910 Marietta Hwy, Roswell, Georgia |
| Authorized Official Name and Position | John Michael Dierkes (PRES) |
| Authorized Official Contact | 6783520919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J Michael Dierkes Family Orthodontics Llc 910 Marietta Hwy Suite Roswell GA 30075-6771 Ph: (678) 352-0919 | J Michael Dierkes Family Orthodontics Llc 910 Marietta Hwy Suite Roswell GA 30075-6771 Ph: (678) 352-0919 |
| NPI Number | 1316107709 |
|---|---|
| Provider Enumeration Date | 06/10/2008 |
| Last Update Date | 12/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316107709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 9675 (Georgia) | Primary |
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