| Ga Sds Iii Pc | |
|
91 W Wieuca Rd Ne Ste 300 Atlanta GA 30342-3248 | |
| (404) 303-7400 | |
| Not Available |
| Full Name | Ga Sds Iii Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 91 W Wieuca Rd Ne Ste 300, Atlanta, Georgia |
| Authorized Official Name and Position | Charlotte E Vial (DIREC OF CRED AND PROV REL) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ga Sds Iii Pc 401 Church St Ste 1400 Nashville TN 37219-2214 Ph: (504) 638-0303 | Ga Sds Iii Pc 91 W Wieuca Rd Ne Ste 300 Atlanta GA 30342-3248 Ph: (404) 303-7400 |
| NPI Number | 1508639535 |
|---|---|
| Provider Enumeration Date | 11/01/2023 |
| Last Update Date | 11/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508639535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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