| Parkside Pediatric And Orthodontic Care Inc | |
|
155 Carnegie Pl Ste 201a Fayetteville GA 30214-3981 | |
| (678) 228-4266 | |
| (404) 521-4120 |
| Full Name | Parkside Pediatric And Orthodontic Care Inc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 155 Carnegie Pl Ste 201a, Fayetteville, Georgia |
| Authorized Official Name and Position | Tarvoria Russ (OPERATIONS MANAGER) |
| Authorized Official Contact | 4046317303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkside Pediatric And Orthodontic Care Inc 155 Carnegie Pl Ste 201a Fayetteville GA 30214-3981 Ph: (678) 228-4266 | Parkside Pediatric And Orthodontic Care Inc 155 Carnegie Pl Ste 201a Fayetteville GA 30214-3981 Ph: (678) 228-4266 |
| NPI Number | 1366125395 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 08/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366125395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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