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2883 North Decatur Rd. Suite F Decatur GA 30033 | |
| (404) 299-7411 | |
| (404) 299-5466 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2883 North Decatur Rd., Decatur, Georgia |
| Authorized Official Name and Position | Amy Mathew (OWNER) |
| Authorized Official Contact | 4042997411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2883 North Decatur Rd. Suite F Decatur GA 30033 Ph: (404) 299-7411 | 2883 North Decatur Rd. Suite F Decatur GA 30033 Ph: (404) 299-7411 |
| NPI Number | 1376929984 |
|---|---|
| Provider Enumeration Date | 08/05/2015 |
| Last Update Date | 08/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376929984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN014228 (Georgia) | Primary |
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