| D4c Of Georgia Llc Lisa Shilman Sole Mbr | |
|
5505 Peachtree Dunwoody Rd Ste 470 Atlanta GA 30342-1717 | |
| (770) 692-1000 | |
| Not Available |
| Full Name | D4c Of Georgia Llc Lisa Shilman Sole Mbr |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5505 Peachtree Dunwoody Rd Ste 470, Atlanta, Georgia |
| Authorized Official Name and Position | Joann Rice (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6093153851 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| D4c Of Georgia Llc Lisa Shilman Sole Mbr 2970 Brandywine Rd Ste 200 Atlanta GA 30341-5549 Ph: (770) 692-1000 | D4c Of Georgia Llc Lisa Shilman Sole Mbr 5505 Peachtree Dunwoody Rd Ste 470 Atlanta GA 30342-1717 Ph: (770) 692-1000 |
| NPI Number | 1972261618 |
|---|---|
| Provider Enumeration Date | 11/30/2021 |
| Last Update Date | 11/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972261618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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