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4324 Covington Hwy Decatur GA 30035-1208 | |
| (404) 289-6454 | |
| (404) 289-2570 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4324 Covington Hwy, Decatur, Georgia |
| Authorized Official Name and Position | Macandrew Robison (OWNER) |
| Authorized Official Contact | 4042896454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4324 Covington Hwy Decatur GA 30035-1208 Ph: (404) 289-6454 | 4324 Covington Hwy Decatur GA 30035-1208 Ph: (404) 289-6454 |
| NPI Number | 1194232892 |
|---|---|
| Provider Enumeration Date | 01/03/2018 |
| Last Update Date | 01/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194232892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN014953 (Georgia) | Primary |
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