| Old Milton Dental | |
|
4165 Old Milton Pkwy Suite 190 Alpharetta GA 30005-4468 | |
| (678) 624-0370 | |
| (678) 624-0319 |
| Full Name | Old Milton Dental |
|---|---|
| Speciality | Dentist |
| Location | 4165 Old Milton Pkwy, Alpharetta, Georgia |
| Authorized Official Name and Position | Corey J Mazer (OWNER) |
| Authorized Official Contact | 6786240370 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Milton Dental 4165 Old Milton Pkwy Suite 190 Alpharetta GA 30005-4468 Ph: (678) 624-0370 | Old Milton Dental 4165 Old Milton Pkwy Suite 190 Alpharetta GA 30005-4468 Ph: (678) 624-0370 |
| NPI Number | 1508085671 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508085671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 012287 (Georgia) | Primary |
| 122300000X | Dentist | 012301 (Georgia) | Secondary |
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