| South Hairston Family Dentistry | |
|
1234 S Hairston Rd Suite 23 Stone Mountain GA 30088-2749 | |
| (404) 294-3600 | |
| Not Available |
| Full Name | South Hairston Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1234 S Hairston Rd, Stone Mountain, Georgia |
| Authorized Official Name and Position | Heather Allen (DENTIST) |
| Authorized Official Contact | 4042943600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Hairston Family Dentistry 1234 S Hairston Rd Suite 23 Stone Mountain GA 30088-2749 Ph: (404) 294-3600 | South Hairston Family Dentistry 1234 S Hairston Rd Suite 23 Stone Mountain GA 30088-2749 Ph: (404) 294-3600 |
| NPI Number | 1598817488 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 09/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598817488 | NPI | - | NPPES |
| 00581215A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10982 (Georgia) | Primary |
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