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11925 Jones Bridge Rd Ste 200 Alpharetta GA 30005-5076 | |
| (770) 772-0606 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11925 Jones Bridge Rd Ste 200, Alpharetta, Georgia |
| Authorized Official Name and Position | Heather Pruemer (CREDENTIALING TEAM LEAD) |
| Authorized Official Contact | 2175408434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11925 Jones Bridge Rd Ste 200 Alpharetta GA 30005-5076 Ph: (770) 772-0606 | 11925 Jones Bridge Rd Ste 200 Alpharetta GA 30005-5076 Ph: (770) 772-0606 |
| NPI Number | 1427502202 |
|---|---|
| Provider Enumeration Date | 08/09/2016 |
| Last Update Date | 08/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427502202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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