GA SOUTHERN DENTAL PPO

ATLANTA, GA
NPI1811723695
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 SOUTHERN DENTAL PPO
857 COLLIER RD NW # 14
ATLANTA, GA 30318-2532
Phone number: 404-355-4952
Mailing Address
GA SOUTHERN DENTAL PPO
5830 GRANITE PKWY STE 780
PLANO, TX 75024-6775
Phone number: 469-596-6137
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