| Pediatric Dentistry Of Johns Creek, Llc | |
|
10475 Medlock Bridge Rd 501 Johns Creek GA 30097-4433 | |
| (678) 822-9818 | |
| (678) 822-9820 |
| Full Name | Pediatric Dentistry Of Johns Creek, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 10475 Medlock Bridge Rd, Johns Creek, Georgia |
| Authorized Official Name and Position | James Hicks (OWERN/DENTIST) |
| Authorized Official Contact | 6788229818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Of Johns Creek, Llc 10475 Medlock Bridge Rd 501 Johns Creek GA 30097-4433 Ph: (678) 822-9818 | Pediatric Dentistry Of Johns Creek, Llc 10475 Medlock Bridge Rd 501 Johns Creek GA 30097-4433 Ph: (678) 822-9818 |
| NPI Number | 1538506720 |
|---|---|
| Provider Enumeration Date | 05/28/2013 |
| Last Update Date | 05/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538506720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN013896 (Georgia) | Primary |
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