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1401 Johnson Ferry Rd Ste 164 Marietta GA 30062-6499 | |
| (470) 795-6677 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1401 Johnson Ferry Rd Ste 164, Marietta, Georgia |
| Authorized Official Name and Position | Daniela Oliveira Lemoine (OWNER/DENTIST) |
| Authorized Official Contact | 4707956677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1401 Johnson Ferry Rd Ste 164 Marietta GA 30062-6499 Ph: (470) 795-6677 | 1401 Johnson Ferry Rd Ste 164 Marietta GA 30062-6499 Ph: (470) 795-6677 |
| NPI Number | 1689395337 |
|---|---|
| Provider Enumeration Date | 09/09/2022 |
| Last Update Date | 01/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689395337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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