| Elite Dentistry | |
|
3052 Shallowford Rd Ste 100 Marietta GA 30062-1252 | |
| (770) 587-5655 | |
| Not Available |
| Full Name | Elite Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3052 Shallowford Rd Ste 100, Marietta, Georgia |
| Authorized Official Name and Position | Kim Wilson (CRED SUP) |
| Authorized Official Contact | 2175405170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dentistry 3052 Shallowford Rd Ste 100 Marietta GA 30062-1252 Ph: (770) 587-5655 | Elite Dentistry 3052 Shallowford Rd Ste 100 Marietta GA 30062-1252 Ph: (770) 587-5655 |
| NPI Number | 1104218361 |
|---|---|
| Provider Enumeration Date | 02/25/2015 |
| Last Update Date | 02/25/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104218361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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