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653 Roberts Dr Ste B Riverdale GA 30274-2959 | |
| (770) 991-9925 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 653 Roberts Dr Ste B, Riverdale, Georgia |
| Authorized Official Name and Position | Sophia Waye Coley (OWNER) |
| Authorized Official Contact | 7709919925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 961480 Riverdale GA 30296-6906 Ph: () - | 653 Roberts Dr Ste B Riverdale GA 30274-2959 Ph: (770) 991-9925 |
| NPI Number | 1457564270 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 01/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457564270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
Smiles Dental Lab, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6030 Highway 85 Ste 240, Riverdale, GA 30274 Phone: 770-996-5737 Fax: 770-996-5916 | |
Daniel Redie General Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1849 Highway 138 Sw, Riverdale, GA 30296 Phone: 770-996-5850 | |