| Kidental | |
|
5972 Roswell Rd Ne Sandy Springs GA 30328-4908 | |
| (404) 256-6400 | |
| (404) 256-6460 |
| Full Name | Kidental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5972 Roswell Rd Ne, Sandy Springs, Georgia |
| Authorized Official Name and Position | Afrin Mariyam (DENTIST) |
| Authorized Official Contact | 4042566400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidental 5972 Roswell Rd Ne Sandy Springs GA 30328-4908 Ph: (404) 256-6400 | Kidental 5972 Roswell Rd Ne Sandy Springs GA 30328-4908 Ph: (404) 256-6400 |
| NPI Number | 1780944983 |
|---|---|
| Provider Enumeration Date | 05/22/2012 |
| Last Update Date | 05/22/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780944983 | NPI | - | NPPES |
| 863488156J | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN012992 (Georgia) | Primary |
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