| Eastside Dental Group | |
|
2055 Beaver Ruin Rd Ste E Norcross GA 30071-3786 | |
| (770) 559-6202 | |
| Not Available |
| Full Name | Eastside Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2055 Beaver Ruin Rd Ste E, Norcross, Georgia |
| Authorized Official Name and Position | Dejuanquaries Stephens (OWNER) |
| Authorized Official Contact | 7705596202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Dental Group 2055 Beaver Ruin Rd Ste E Norcross GA 30071-3786 Ph: (770) 559-6202 | Eastside Dental Group 2055 Beaver Ruin Rd Ste E Norcross GA 30071-3786 Ph: (770) 559-6202 |
| NPI Number | 1326855396 |
|---|---|
| Provider Enumeration Date | 12/13/2024 |
| Last Update Date | 12/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326855396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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