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3005 Royal Blvd S Suite 200 Alpharetta GA 30022-1409 | |
| (770) 680-2335 | |
| (678) 550-3046 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3005 Royal Blvd S, Alpharetta, Georgia |
| Authorized Official Name and Position | Amanda Bullock (PRACTICE MANAGER) |
| Authorized Official Contact | 7706802335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3005 Royal Blvd S Suite 200 Alpharetta GA 30022-1409 Ph: (770) 680-2335 | 3005 Royal Blvd S Suite 200 Alpharetta GA 30022-1409 Ph: (770) 680-2335 |
| NPI Number | 1518355577 |
|---|---|
| Provider Enumeration Date | 12/29/2014 |
| Last Update Date | 12/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518355577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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