| Muccioli Dental, Pc | |
|
6300 Hospital Pkwy Suite 275 Johns Creek GA 30097-1828 | |
| (678) 389-9955 | |
| (678) 389-9952 |
| Full Name | Muccioli Dental, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6300 Hospital Pkwy, Johns Creek, Georgia |
| Authorized Official Name and Position | Randy Earl Muccioli (OWNER/DENTIST) |
| Authorized Official Contact | 6783899955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Muccioli Dental, Pc 6300 Hospital Pkwy Suite 275 Johns Creek GA 30097-1828 Ph: (678) 389-9955 | Muccioli Dental, Pc 6300 Hospital Pkwy Suite 275 Johns Creek GA 30097-1828 Ph: (678) 389-9955 |
| NPI Number | 1558796896 |
|---|---|
| Provider Enumeration Date | 09/05/2013 |
| Last Update Date | 09/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558796896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN014378 (Georgia) | Primary |
| 1223P0700X | Dentist - Prosthodontics | DN014379 (Georgia) | Secondary |
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