| Jamestown Condottiere Implant&general Dentistry Ctr. P.c. | |
|
2457 Riverdale Rd Atlanta GA 30337-5003 | |
| (404) 767-9356 | |
| (404) 529-4465 |
| Full Name | Jamestown Condottiere Implant&general Dentistry Ctr. P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2457 Riverdale Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Aldous Wilson (OWNER) |
| Authorized Official Contact | 4047679356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jamestown Condottiere Implant&general Dentistry Ctr. P.c. 2457 Riverdale Rd Atlanta GA 30350 Ph: (404) 767-9356 | Jamestown Condottiere Implant&general Dentistry Ctr. P.c. 2457 Riverdale Rd Atlanta GA 30337-5003 Ph: (404) 767-9356 |
| NPI Number | 1801069240 |
|---|---|
| Provider Enumeration Date | 04/07/2008 |
| Last Update Date | 04/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801069240 | NPI | - | NPPES |
| 00809025B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DNO11947 (Georgia) | Primary |
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