| Proud Smiles Dental | |
|
5290 Roswell Rd Ne Suite F Atlanta GA 30342-1978 | |
| (404) 257-0091 | |
| (404) 843-0264 |
| Full Name | Proud Smiles Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5290 Roswell Rd Ne, Atlanta, Georgia |
| Authorized Official Name and Position | John Sampson (CFO & PRACTICE MANAGER) |
| Authorized Official Contact | 4042570091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proud Smiles Dental 5290 Roswell Rd Suite F Atlanta GA 30342-1978 Ph: (404) 257-0091 | Proud Smiles Dental 5290 Roswell Rd Ne Suite F Atlanta GA 30342-1978 Ph: (404) 257-0091 |
| NPI Number | 1588748677 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 05/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588748677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN010235 (Georgia) | Primary |
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