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401 S Main St Ste B1 Alpharetta GA 30009-1958 | |
| (770) 569-5333 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 401 S Main St Ste B1, Alpharetta, Georgia |
| Authorized Official Name and Position | Val Kolpakov (OWNER) |
| Authorized Official Contact | 7705695333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
401 S Main St Ste B1 Alpharetta GA 30009-1958 Ph: (770) 569-5333 | 401 S Main St Ste B1 Alpharetta GA 30009-1958 Ph: (770) 569-5333 |
| NPI Number | 1285860155 |
|---|---|
| Provider Enumeration Date | 06/05/2009 |
| Last Update Date | 06/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285860155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN013657 (Georgia) | Primary |
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