Kotzqualitydental Llc | |
4112 Atlanta Hwy Ste 100 Loganville GA 30052-4930 | |
(470) 385-3595 | |
Not Available |
Full Name | Kotzqualitydental Llc |
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Speciality | Dentist - General Practice |
Location | 4112 Atlanta Hwy Ste 100, Loganville, Georgia |
Authorized Official Name and Position | Michelle Jacomino-barnes (DIRECTOR CREDENTIALING & ENROLLMENT) |
Authorized Official Contact | 8132709497 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Kotzqualitydental Llc Po Box 70887 Cleveland OH 44190-0887 Ph: () - | Kotzqualitydental Llc 4112 Atlanta Hwy Ste 100 Loganville GA 30052-4930 Ph: (470) 385-3595 |
NPI Number | 1881372613 |
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Provider Enumeration Date | 07/11/2023 |
Last Update Date | 09/14/2023 |
Identifier | Type | State | Issuer |
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1881372613 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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