| Childrens Dentistry At Stonecrest | |
|
8180 Mall Pkwy 810 Lithonia GA 30038-6911 | |
| (770) 484-4994 | |
| (770) 484-4575 |
| Full Name | Childrens Dentistry At Stonecrest |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 8180 Mall Pkwy, Lithonia, Georgia |
| Authorized Official Name and Position | Sonya Lynette Windham (OWNER/OPERATOR) |
| Authorized Official Contact | 7704844994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Dentistry At Stonecrest 8180 Mall Pkwy 810 Lithonia GA 30038-6911 Ph: (770) 484-4994 | Childrens Dentistry At Stonecrest 8180 Mall Pkwy 810 Lithonia GA 30038-6911 Ph: (770) 484-4994 |
| NPI Number | 1790046464 |
|---|---|
| Provider Enumeration Date | 05/30/2012 |
| Last Update Date | 03/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790046464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN012294 (Georgia) | Primary |
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