| Pediatric Smile Studio | |
|
2526 Shallowford Rd Suite C Marietta GA 30066-3053 | |
| (678) 813-0500 | |
| (678) 813-0600 |
| Full Name | Pediatric Smile Studio |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2526 Shallowford Rd, Marietta, Georgia |
| Authorized Official Name and Position | Eileen Buckle (DENTIST) |
| Authorized Official Contact | 6789825130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Smile Studio 2526 Shallowford Rd Suite C Marietta GA 30066-3053 Ph: (678) 813-0500 | Pediatric Smile Studio 2526 Shallowford Rd Suite C Marietta GA 30066-3053 Ph: (678) 813-0500 |
| NPI Number | 1619313384 |
|---|---|
| Provider Enumeration Date | 05/21/2013 |
| Last Update Date | 05/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619313384 | NPI | - | NPPES |
| 003108300 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN014232 (Georgia) | Primary |
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