| Pedozone, LLC | |
|
8879 Dallas Acworth Hwy Dallas GA 30132-7905 | |
| (770) 974-3633 | |
| (770) 974-3660 |
| Full Name | Pedozone, LLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8879 Dallas Acworth Hwy, Dallas, Georgia |
| Authorized Official Name and Position | Crystal Deann Smith (TREATMENT COORDINATOR) |
| Authorized Official Contact | 7709743633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pedozone, LLC 3104 Creekside Village Dr Nw Ste 401 Kennesaw GA 30144-2393 Ph: (770) 974-3633 | Pedozone, LLC 8879 Dallas Acworth Hwy Dallas GA 30132-7905 Ph: (770) 974-3633 |
| NPI Number | 1952812737 |
|---|---|
| Provider Enumeration Date | 10/19/2017 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952812737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DNO14556 (Georgia) | Primary |
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