| Stone Mountain Dental 2, Pc | |
|
3100 Five Forks Trickum Rd Sw Ste 402 Lilburn GA 30047-1887 | |
| (770) 837-9832 | |
| (404) 445-8499 |
| Full Name | Stone Mountain Dental 2, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3100 Five Forks Trickum Rd Sw Ste 402, Lilburn, Georgia |
| Authorized Official Name and Position | Nikki Rolls (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 4044521164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stone Mountain Dental 2, Pc 3100 Five Forks Trickum Rd Sw Ste 402 Lilburn GA 30047-1887 Ph: (770) 837-9832 | Stone Mountain Dental 2, Pc 3100 Five Forks Trickum Rd Sw Ste 402 Lilburn GA 30047-1887 Ph: (770) 837-9832 |
| NPI Number | 1548810997 |
|---|---|
| Provider Enumeration Date | 09/18/2019 |
| Last Update Date | 09/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548810997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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