| Pediatric Dental Specialist Of Hiram | |
|
5604 Wendy Bagwell Pkwy Suite 1100 Hiram GA 30141-7813 | |
| (770) 943-0011 | |
| Not Available |
| Full Name | Pediatric Dental Specialist Of Hiram |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5604 Wendy Bagwell Pkwy, Hiram, Georgia |
| Authorized Official Name and Position | Mindy Lynn Simms (PRESIDENT) |
| Authorized Official Contact | 3302896019 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Specialist Of Hiram 5604 Wendy Bagwell Pkwy Suite 1100 Hiram GA 30141-7813 Ph: (770) 943-0011 | Pediatric Dental Specialist Of Hiram 5604 Wendy Bagwell Pkwy Suite 1100 Hiram GA 30141-7813 Ph: (770) 943-0011 |
| NPI Number | 1245617364 |
|---|---|
| Provider Enumeration Date | 04/27/2015 |
| Last Update Date | 04/27/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245617364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DN013367 (Georgia) | Primary |
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Jason E. Turner, Dmd, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 Enterprise Path, Suite 106, Hiram, GA 30141 Phone: 770-439-9119 Fax: 770-439-9194 |