| Kennesaw Modern Dentistry | |
|
1125 Ernest W Barrett Pkwy Nw Bldg 200 Kennesaw GA 30144-4535 | |
| (678) 832-0527 | |
| (678) 835-9729 |
| Full Name | Kennesaw Modern Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 1125 Ernest W Barrett Pkwy Nw Bldg 200, Kennesaw, Georgia |
| Authorized Official Name and Position | Michelle Houston (OWNER) |
| Authorized Official Contact | 6788320527 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennesaw Modern Dentistry Po Box 920050 Dallas TX 75392-0050 Ph: (714) 845-8500 | Kennesaw Modern Dentistry 1125 Ernest W Barrett Pkwy Nw Bldg 200 Kennesaw GA 30144-4535 Ph: (678) 832-0527 |
| NPI Number | 1477200137 |
|---|---|
| Provider Enumeration Date | 03/03/2022 |
| Last Update Date | 04/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477200137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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