| Greenlea Dental Center Pc | |
|
6740 Shannon Pkwy Ste 2 Union City GA 30291-2058 | |
| (770) 306-2996 | |
| (770) 306-0004 |
| Full Name | Greenlea Dental Center Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6740 Shannon Pkwy Ste 2, Union City, Georgia |
| Authorized Official Name and Position | Judy Taylor (DENTIST) |
| Authorized Official Contact | 7703062996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenlea Dental Center Pc 6740 Shannon Pkwy Ste 2 Union City GA 30291-2058 Ph: (770) 306-2996 | Greenlea Dental Center Pc 6740 Shannon Pkwy Ste 2 Union City GA 30291-2058 Ph: (770) 306-2996 |
| NPI Number | 1013132372 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013132372 | NPI | - | NPPES |
| 00521298A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | GA10999 (Georgia) | Primary |
South Fulton Dental Care, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4550 Jonesboro Rd Ste 1a, Union City, GA 30291 Phone: 770-306-2266 Fax: 770-306-9111 |