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1203 Cleveland Ave Ste 1a East Point GA 30344-3417 | |
| (404) 595-5104 | |
| (404) 601-7777 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1203 Cleveland Ave Ste 1a, East Point, Georgia |
| Authorized Official Name and Position | Kisha Carter (OWNER) |
| Authorized Official Contact | 4045955104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1203 Cleveland Ave Ste 1a East Point GA 30344-3417 Ph: (404) 595-5104 | 1203 Cleveland Ave Ste 1a East Point GA 30344-3417 Ph: (404) 595-5104 |
| NPI Number | 1821499542 |
|---|---|
| Provider Enumeration Date | 09/12/2014 |
| Last Update Date | 02/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821499542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN013722 (Georgia) | Primary |
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