| Epp Georgia LLC | |
|
3275 Market Place Blvd Ste 200 Cumming GA 30041-7978 | |
| (770) 781-5990 | |
| Not Available |
| Full Name | Epp Georgia LLC |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 3275 Market Place Blvd Ste 200, Cumming, Georgia |
| Authorized Official Name and Position | Vicki Gorlitz (CONTRACTING & CREDENTIALING MANAGER) |
| Authorized Official Contact | 2485059977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Epp Georgia LLC 5115 Maryland Way Ste 115 Brentwood TN 37027-7512 | Epp Georgia LLC 3275 Market Place Blvd Ste 200 Cumming GA 30041-7978 Ph: (770) 781-5990 |
| NPI Number | 1306463286 |
|---|---|
| Provider Enumeration Date | 06/26/2020 |
| Last Update Date | 06/26/2020 |
| Certification Date | 06/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306463286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | () | Primary |
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