| Lithonia Pediatric Dentistry-stonecrest Inc | |
|
7215 Stonecrest Pkwy Lithonia GA 30038-2563 | |
| (770) 482-4661 | |
| (770) 482-4606 |
| Full Name | Lithonia Pediatric Dentistry-stonecrest Inc |
|---|---|
| Speciality | Dentist |
| Location | 7215 Stonecrest Pkwy, Lithonia, Georgia |
| Authorized Official Name and Position | Young Tae Shim (DENTIST) |
| Authorized Official Contact | 7704824661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lithonia Pediatric Dentistry-stonecrest Inc 7215 Stonecrest Pkwy Lithonia GA 30038-2563 Ph: (770) 482-4661 | Lithonia Pediatric Dentistry-stonecrest Inc 7215 Stonecrest Pkwy Lithonia GA 30038-2563 Ph: (770) 482-4661 |
| NPI Number | 1285973230 |
|---|---|
| Provider Enumeration Date | 02/12/2013 |
| Last Update Date | 02/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285973230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN013999 (Georgia) | Primary |
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