| |
2005 Boggs Rd, #107, Duluth, GA 30096-4601 | |
(770) 497-0885 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Dentist - General Practice |
Location | 2005 Boggs Rd, Duluth, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
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1063948750 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CHIR005434 (Georgia) | Secondary |
1223G0001X | Dentist - General Practice | DN013766 (Georgia) | Primary |
Mailing Address | Practice Location Address |
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2005 Boggs Rd, #107, Duluth, GA 30096-4601 Ph: (770) 497-0885 | 2005 Boggs Rd, #107, Duluth, GA 30096-4601 Ph: (770) 497-0885 |