| Super Smiles Pc | |
|
2058 N Decatur Rd Decatur GA 30033-5306 | |
| (404) 636-1200 | |
| (404) 636-1199 |
| Full Name | Super Smiles Pc |
|---|---|
| Speciality | Dentist |
| Location | 2058 N Decatur Rd, Decatur, Georgia |
| Authorized Official Name and Position | Francis P Shaeffer (DOCTOR) |
| Authorized Official Contact | 4046361200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Super Smiles Pc 2058 N Decatur Rd Decatur GA 30033-5306 Ph: (404) 636-1200 | Super Smiles Pc 2058 N Decatur Rd Decatur GA 30033-5306 Ph: (404) 636-1200 |
| NPI Number | 1295992055 |
|---|---|
| Provider Enumeration Date | 05/20/2008 |
| Last Update Date | 05/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295992055 | NPI | - | NPPES |
| 425180080B | Other | GA | MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 012746 (Georgia) | Primary |
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