| Canton Office | |
|
2205 Riverstone Blvd Suite 205 Canton GA 30114-5227 | |
| (678) 493-6693 | |
| (678) 493-6694 |
| Full Name | Canton Office |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 2205 Riverstone Blvd, Canton, Georgia |
| Authorized Official Name and Position | Richardson Michael Odum (PRESIDENT) |
| Authorized Official Contact | 6784936693 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canton Office 2205 Riverstone Blvd Suite 205 Canton GA 30114-5227 Ph: (678) 493-6693 | Canton Office 2205 Riverstone Blvd Suite 205 Canton GA 30114-5227 Ph: (678) 493-6693 |
| NPI Number | 1700058302 |
|---|---|
| Provider Enumeration Date | 03/24/2008 |
| Last Update Date | 03/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700058302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 10232, 10416 (Georgia) | Primary |
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Canton Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 Riverstone Pkwy, Suite A, Canton, GA 30114 Phone: 770-479-5425 Fax: 770-479-0291 | |
Dameron Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6199 Hickory Flat Hwy, Suite 130, Canton, GA 30115 Phone: 770-345-8646 | |
Canton Smiles Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1425 Riverstone Pkwy Ste 200, Canton, GA 30114 Phone: 770-479-0600 Fax: 770-479-0599 | |
Lewis Family Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7768 Cumming Hwy, Suite 100, Canton, GA 30114 Phone: 678-493-2204 Fax: 678-493-2275 | |
Greg Elwell, D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Waleska St, Canton, GA 30114 Phone: 770-479-5569 Fax: 770-479-3492 | |
Sage Dental Group Of Georgia, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3750 Sixes Rd, Canton, GA 30114 Phone: 561-999-9650 |