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300 Walnut Grove Rd Se Cartersville GA 30120-6431 | |
| (770) 727-2211 | |
| (770) 727-2213 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 300 Walnut Grove Rd Se, Cartersville, Georgia |
| Authorized Official Name and Position | Amanda W. Conti (PRESIDENT) |
| Authorized Official Contact | 7707272211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
300 Walnut Grove Rd Se Cartersville GA 30120-6431 Ph: (770) 727-2211 | 300 Walnut Grove Rd Se Cartersville GA 30120-6431 Ph: (770) 727-2211 |
| NPI Number | 1609092279 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 10/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609092279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 11537 (Georgia) | Primary |
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