| Mini Smiles Pediatric Dentistry, Pc | |
|
1400 Dogwood Dr Se Conyers GA 30013-5037 | |
| (770) 761-5690 | |
| (770) 761-9750 |
| Full Name | Mini Smiles Pediatric Dentistry, Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1400 Dogwood Dr Se, Conyers, Georgia |
| Authorized Official Name and Position | Keysra M Washington (OWNER/DENTIST) |
| Authorized Official Contact | 7707615690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mini Smiles Pediatric Dentistry, Pc 1400 Dogwood Dr Se Conyers GA 30013-5037 Ph: (770) 761-5690 | Mini Smiles Pediatric Dentistry, Pc 1400 Dogwood Dr Se Conyers GA 30013-5037 Ph: (770) 761-5690 |
| NPI Number | 1184059073 |
|---|---|
| Provider Enumeration Date | 09/10/2013 |
| Last Update Date | 02/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184059073 | NPI | - | NPPES |
| 1376603308 | Other | TX | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN013140 (Georgia) | Primary |
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