| Professional Corporation | |
|
4849 South Cobb Drive Se Smyrna GA 30080 | |
| (770) 435-5450 | |
| (770) 436-7477 |
| Full Name | Professional Corporation |
|---|---|
| Speciality | Dentist |
| Location | 4849 South Cobb Drive Se, Smyrna, Georgia |
| Authorized Official Name and Position | Robin S Reich (PRESIDENT) |
| Authorized Official Contact | 7704355450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Corporation 4480 S Cobb Dr Se Ste H Suite 530 Smyrna GA 30080-6984 Ph: (770) 435-5450 | Professional Corporation 4849 South Cobb Drive Se Smyrna GA 30080 Ph: (770) 435-5450 |
| NPI Number | 1346258324 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346258324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 10035 (Georgia) | Primary |
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