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3652 Chamblee Dunwoody Rd Suite 5 Atlanta GA 30341-2120 | |
| (770) 451-0451 | |
| (770) 936-9774 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3652 Chamblee Dunwoody Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Mehron Haidari (PRESIDENT) |
| Authorized Official Contact | 7704510451 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3652 Chamblee Dunwoody Rd Suite 5 Atlanta GA 30341-2120 Ph: (770) 451-0451 | 3652 Chamblee Dunwoody Rd Suite 5 Atlanta GA 30341-2120 Ph: (770) 451-0451 |
| NPI Number | 1306060595 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306060595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN012920 (Georgia) | Primary |
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