GA SOTHERN DENTAL PPO

MARIETTA, GA
NPI1750117537
Doing Business AsNATURAL SMILES DENTISTRY
Entity TypeOrganization
Authorized ContactERIKA MELISSA MENJIVAR
Sr. Credentialing Specialist
469-596-6137
Organization Subpart ?Yes
Primary Taxonomy122300000X Dentist
Enumeration Date2024-09-10
Last Update Date2024-09-10
Business Address
GA SOTHERN DENTAL PPO
3911 MARY ELIZA TRCE NW STE 100
MARIETTA, GA 30064-1087
Phone number: 770-362-6417
Mailing Address
GA SOTHERN DENTAL PPO
5830 GRANITE PKWY STE 780
PLANO, TX 75024-6775
Phone number: 469-596-6137