| Family Dental Centers Of Marietta, P.c. | |
|
683 Piedmont Rd Ne Marietta GA 30066-4811 | |
| (770) 794-0808 | |
| Not Available |
| Full Name | Family Dental Centers Of Marietta, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 683 Piedmont Rd Ne, Marietta, Georgia |
| Authorized Official Name and Position | Hetesh Madev Ranchod (PRESIDENT) |
| Authorized Official Contact | 7707940808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Centers Of Marietta, P.c. 683 Piedmont Rd Ne Marietta GA 30066-4811 Ph: (770) 794-0808 | Family Dental Centers Of Marietta, P.c. 683 Piedmont Rd Ne Marietta GA 30066-4811 Ph: (770) 794-0808 |
| NPI Number | 1396864237 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 01/16/2020 |
| Medicare PECOS PAC ID | 4587683461 |
|---|---|
| Medicare Enrollment ID | O20160503002705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396864237 | NPI | - | NPPES |
| 100696 | Medicaid | GA | |
| 000683229B | Medicaid | GA | |
| 107742 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN011401 (Georgia) | Primary |
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