Eastlight Dental, L.l.c. | |
2536 Rockbridge Rd Ste 103 Stone Mountain GA 30087-3636 | |
(678) 395-5913 | |
Not Available |
Full Name | Eastlight Dental, L.l.c. |
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Speciality | Clinic/center - Dental |
Location | 2536 Rockbridge Rd Ste 103, Stone Mountain, Georgia |
Authorized Official Name and Position | Edmund Thomas (OWNER) |
Authorized Official Contact | 7169492183 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Eastlight Dental, L.l.c. 2536 Rockbridge Rd Ste 103 Stone Mountain GA 30087-3636 Ph: (678) 395-5913 | Eastlight Dental, L.l.c. 2536 Rockbridge Rd Ste 103 Stone Mountain GA 30087-3636 Ph: (678) 395-5913 |
NPI Number | 1689152282 |
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Provider Enumeration Date | 08/06/2018 |
Last Update Date | 09/18/2018 |
Identifier | Type | State | Issuer |
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1689152282 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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